Day-to-Day Medical Plans for You and Your Family
A day-to-day plan covers your daily medical costs which can be more expensive than hospital care
Do I need day-to-day cover?
Your daily medical bills can be more expensive than a hospital stay. Yet most of us focus on hospital cover which we may not use for years. A single GP consultation can be over R500 while some specialists charge as much as R2,000 per visit. Add on the medication and blood tests and you could be out of pocket for thousands of rands without needing to be hospitalised.
This is where a day-to-day medical plan can save you money and allow you access to private healthcare. Day-to-day medical plans focus on your daily needs. It can serve as top up cover if you have a hospital plan medical aid or even serve as standalone cover for daily medical bills. There are a range of plans to suit individuals, families and even seniors.
What is day-to-day medical cover?
Day-to-day medical plans cover your daily out-of-hospital medical costs. It is intended to help South Africans afford private healthcare with GP and specialist visits as well medication, blood tests, x-rays and basic dentistry. A day-to-day medical plan covers your basic healthcare needs and provides extra services for maternity and optometry. Emergency medical response is also included in the cover.
How does day-to-day medical cover work?
Similar to medical aid cover, a day-to-day medical plan covers your treatment and management by a private practitioner. However, day-to-day medical cover is not a medical aid. It is a convenient additional cover if you only have a hospital plan medical aid. Even if you do not have medical aid cover, you can still opt for a day-to-day plan. Payments are made directly to qualifying practitioners or you are reimbursed for medical costs.
Can I cover my family?
Yes. There are plans for individuals and families. All dependents can be covered under one family plan with varying rates for adult dependents (over 18) and child dependents (under 18). Depending on the plan, seniors can also be included subject to the insurer's criteria. Family cover has more extensive benefits to ensure that all family members can access healthcare with a large cover limit.
Will seniors be covered?
Yes. Seniors can also be covered under certain medical plans, subject to the insurer's criteria. Whether as individuals or a family, seniors will pay more per month as their healthcare needs tend to be more extensive. Pre-existing conditions may be subject to a waiting period after which the medical plan will also cover the treatment and management of these conditions subject to the plan's benefits.
Are there benefit limits?
Yes. Limits apply to all benefits including the unlimited GP consults. This is to prevent abuse by members and over-servicing by doctors. Some benefits, like specialists visits, are covered to a maximum per year. Other benefits like unlimited GP consults will be monitored and authorisation will be needed for further consults after the first 10 visits. It ensures that members get access to private healthcare when they legitimately need care.