EXECUTIVE PLAN

From* R 925

PLEASE NOTE : Plan prices and benefits are effective from the 1st of March 2017

Executive Health Insurance Plan

Our plans and pricing comparison – click here for all the information

Health Cover Waiting Periods Cover Limits Single Dep(2-3) Dep(4+)
General Practitioner (Doctor) 30 Days Up to R 315 per visit R2 740 R4 560 R5 470
Scripted Medication 30 Days Up to R235 per script. Paid through Mediscor
electronic claim system. No over
counter medication.
R1 505 R1 980 R2 405
Pathology 30 Days Up to R540 per event. R2 885 R3 850 R4 930
Radiology 30 Days Up to R540 per event. R2 160 R3 850 R5 410
Dentistry 90 Days Up to R720 per visit. Max of 4 visits a year. R2 700 R3 605 R4 805
Specialist Cover 90 Days Up to R1 800 per visit. 3 visits per family per year.
Referral from GP required and subject to authorisation.
Maternity Pre Birth 7 Months applicable to new policies.

Thereafter waiting period of 4 months from date of conception.

Up to R490 per visit. 4 Visits per Pregnancy.
Annual limit of R 1925.
Optometry 12 Months Up to R1 220 - Limited to claim this every
24 months per dependant.
Maximum overall limits for Health Cover of: Single: R17 460 2 or 3: R24 280 4 plus: R29 140
Hospital Risk Cover Waiting Periods Cover Limits Excess
Emergency Illness 90 Days Up to R4800 for life threatening emergency illness
in casualty units.
Excess:4 months plus - R200
Emergency Accident Immediate Up to R4800 for accident events in casualty units
that does not result in admission.
Excess:0-3 Months - 15 % | 4 months plus -R200
Accident Cover Immediate Up to R265 000 per insured event. Up to R530 000 per family
per event.
Excess: R500 | Contact sport -15% of claim amount
(12 months waiting period)
Illness In Hospital 90 days
Certain conditions are excluded for 12 months.
Up to R60 000 per insured event p/p. Up to R120 000 per insured per year.
Excess:4-6 Months - 15% | 7 months onwards - 5%
Dread Disease 6 Months Up to R300 000 per defined disease per year.
Natural Birth and
Emergency Caesareans
12 Months Up to R57 000 per insured event p/p. Cover forms part
of illness and operations annual limits.
Excess: 10% of claim amount.
Accident Disability Immediate Up to R147 000 for the duration fo the policy.
only principal insured is covered.
Family Death Cover Accidental Death:
(Immediate)
Natural Death:
90 Days
Principal Insured: R12 000 | Spouse/Partner:R12 000 | Children 14-21 yrs:R12 000
Children 6-13 yrs R6 000 | Children 1-5 yrs R3 000
Children unborn(28 weeks) ro Oyrs: R1 500
Trauma,Assault and
Accidental HIV
Immediate Trauma and assault counselling, Accidental HIV protection services.
Accidental HIV infection treatment.
Repatriation Immediate Up to R12 000 per insured person. Repatriation of mortal remains to funeral home.
Ambulance and
Emergency Services
Immediate 24 hr Medical assistance with an emergency dedicated line.
In the event of a justifiable,life-threatening medical emergency,
the insured will be transported by ambulance to the nearest
appropriate medical facility.