Important Things to Remember

Platinum Plan

  • All GP consultations are unlimited but managed. At all times you have to be registered with a 1Doctor Health Network Provider. If you are out of town and you cannot see your Network GP, the Day to Day Plan will allow 3 “out-of-area” visits per family per annum to an alternative Network GP or GP of your choice. Should you have to pay for these consultations, simply complete a Day1 Health Reimbursement Form and send it to Day1 Health together with a copy of the receipt and the agreed tariff will be reimbursed to you.
  • Day1 Health is contracted to certain GP’s and Dentists as per the Network list on our website. All pathology, radiology and specialist claims must be settled upfront directly with the provider. A duly completed reimbursement form must then be submitted to Day1 Health to claim a refund, limited to the formulary benefit applicable. Day1 Health will not be held liable for any legal costs incurred due to the non-payment upfront of service provider accounts.
  • Both acute routine and chronic medication are covered and are unlimited according to the 1Doctor Health formulary. The Network GP’s usually dispense the medication; however, if the GP is a scripting doctor, i.e. ‘does not dispense’, you may obtain your medication from any Clicks, Dischem or Medirite pharmacy. If you are diagnosed with a chronic condition, you must register on the 1Doctor Health Chronic Disease Management Programme via your 1Doctor Health Network GP in order to receive your chronic medication. Chronic medication may be collected from any Clicks, Dischem or Medirite pharmacy and is subject to pre-authorisation.
  • You may make use of any 1Doctor Health Network Dentist.
  • Please make sure that you keep your Day1 membership card with you at all times.
Senior Plan

  • Persons joining over the age of 65 will be subject to a late joiner penalty fee of up to 75% on monthly contribution.
  • All GP consultations are unlimited but managed. At all times you have to be registered with a 1Doctor Health Network Provider. If you are out of town and you cannot see your Network GP, the Day to Day Plan will allow 3 “out-of-area” visits per family per annum to an alternative Network GP or GP of your choice. Should you have to pay for these consultations, simply complete a Day1 Health Reimbursement Form and send it to Day1 Health together with a copy of the receipt and the agreed tariff will be reimbursed to you.
  • Day1 Health is only contracted to certain GP’s and Dentist’s as per our network list available on the Day1 Health website. The onus is upon each member to make sure any pathology, radiology and specialist claims are settled with the provider upfront or to take responsibility upon themselves to make sure the claims reach Day1 Health’s office for processing. None of the above mentioned service providers are aware of Day1’s claiming procedure. Day1 Health will not be held responsible for any legal costs incurred if claims are not paid in this regard.
  • Both acute routine and chronic medication are covered and are unlimited according to the 1Doctor Health formulary. The Network GP’s usually dispense the medication; however, if the GP is a scripting doctor, i.e. ‘does not dispense’, you may obtain your medication from any Clicks, Dischem or Medirite pharmacy. If you are diagnosed with a chronic condition, you must register on the 1Doctor Health Chronic Disease Management Programme via your 1Doctor Health Network GP in order to receive your chronic medication. Chronic medication may be collected from any Clicks, Dischem or Medirite pharmacy and is subject to pre-authorisation.
  • You may make use of any 1Doctor Health Network Dentist.
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Day1 Health (Pty) Ltd is a registered Financial Services Provider. FSP No: 11319
Hospital Plan Underwritten by African Unity Insurance Limited (FSP 8447)