Executive Plan

Via a registered 1Doctor Health Network Provider. A co-payment of R75.00 will apply for all additional visits after the 5th visit. A 1 month waiting period applies.

Basic diagnostic blood tests on referral by a 1Doctor Health Network GP and subject to a list of basic pathology tests approved by Day1 Health. A 1 month waiting period applies.

Specialist Benefit of up to R 1000 per family per annum. Subject to pre-authorisation and referral from a 1Doctor Health Network GP. A 3 month waiting period applies.

Basic treatment includes preventative cleaning, fillings, extractions and emergency pain and sepsis control via a 1Doctor Health Network Dentist. 2 visits per annum per member. A 3 month waiting period applies.

Chronic medication covered according to the 1Doctor Health formulary. A 3 month waiting period applies on chronic medication for unknown conditions and 12 months waiting period on pre-existing conditions. (All chronic medication is subject to pre-authorisation. An additional administration fee may be levied on all approved chronic medication.)

One eye test and one set of glasses every 24 months per the specific Iso Leso Optics agreed protocol range. A 12 month waiting period applies.

Basic radiology according to the 1Doctor Health formulary via a 1Doctor Health network GP. Black and white diagnostic x-rays only. A 1 month waiting period applies.

In the event that you cannot see your Network GP, the Plan will allow 3 “out of area” visits per family per annum to an alternative Network GP or GP of your choice, subject to pre-authorisation. A 1 month waiting period applies.

Covers up to R10,000 after the first 24 Hours in hospital, up to R10,000 for the second day in hospital, up to R10,000 for the third day in hospital. Thereafter R1,500 per day up to a maximum of 21 days. A 3 month waiting period applies and a 12 month pre-existing conditions exclusion applies.

Up to R25,000 per insured person per year subject to an overall limit of 2 events per family policy per annum. A 3 month waiting period applies

Up to R250,000 per single member per incident and up to R500,000 per family per incident. Immediate cover.

1 Incident per family per annum

Critical Illness up to R250,000, however the benefit is limited to R50,000 unless the insured person accedes to a short medical examination (at their own cost) to be arranged by Day1 Health.The underwriter’s decision is final. A 3 month waiting period applies.

R 250 000 for the Principal Member only. Single event only. Immediate cover.

• Principal member & Spouse – R 30,000.
• Child > 14 years – R 10,000.
• Child > 6 years  – R 5,000.
• Child > 0 years – R 2,500.
• Child > 28 weeks – R1,250.

A 3-month waiting period applies.  (Benefit only available to plan members.)

24 Hour Emergency Services, Medical Assistance and Pre-Authorisation provided by Africa Assist. Immediate Cover. Guaranteed private hospital admission with preference to all Life Healthcare and Mediclinic hospitals