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Wellness Brokers in Durban

Gap Cover

Gap benefit is unlimited

• Covers the insured for doctor and specialist shortfalls incurred as an in-hospital patient;

• An additional gap benefit of 500% over and above the medical scheme rate of 100% is provided;

In-hospital procedure related co-payments including :

• Out-patient MRI and CT scans;

• In-hospital pre-admission co-payments;

• Benefit limited to R 35 000.00 per family per annum;

Benefit includes :

• 20% Co-payment above the medical scheme's sub-limit;

• Sub-limits related to biological drugs as per Stratum Benefits formulary;

• Benefit limited to R 250 000.00 per family per annum;

• 6 Months Stratum premium waiver benefit;

• Accidental death cover for the principle insured and spouse limited to R 5 000.00 per life;

Covers shortfalls for :

• In-hospital radiology (x-rays) and pathology limited to R 12 000.00 per insured per annum;

• In-hospital consumable items limited to R 6 000.00 per insured per annum;

• In-hospital wisdom teeth extractions limited to R 5 000.00 per child dependant under the age of 21 per annum.

• 12 Months pre-existing condition waiting period

• * Total exclusion for any pre-diagnosed cancer

(only applicable to the Cancer Cover benefit)

• Maximum entry age 70

The following conditions are excluded for the first

12 months of the policy :

• Tonsillectomy

• Grommets

• Adenoids

• Hysterectomy (unless malignant)

• Pregnancy and childbirth

• Joint replacement (unless accidental)

• Hernia operations (unless an emergency)

3 Months general waiting period

Premium

R 155.00 (individual)

R 181.00 (family)

  • Medical Aid

    Wellness Brokers specializes in medical aid and related benefits. Wellness Brokers advises you on the various medical scheme benefits. Whether you are looking for a hospital plan, capitated options(network options),or traditional medical options Wellness Brokers will be able to advise you on the appropriatly.
    • Medical Aid
    • Medical Aid
  • In-Hospital Gap Evolution

    Gap benefit is unlimited.

    • Covers the insured for doctor and specialist shortfalls incurred as an in-hospital patient;

    • An additional gap benefit of 500% over and above the medical scheme rate of 100% is provided;

    Additional Cover

    In-hospital procedure-related co-payments including :

    • Out-patient MRI and CT scans;

    • In-hospital pre-admission co-payments;

    • Benefit limited to R 35 000.00 per family per annum;

    Covers shortfalls for :

    • In-hospital radiology (x-rays) and pathology limited to

    R 12 000.00 per insured per annum;

    • In-hospital consumable items limited to R 6 000.00 per insured per annum.

    Underwriting Criteria

    • 12 Months pre-existing condition waiting

    period

    • Maximum entry age 70

    The following conditions are excluded for the

    first 12 months of the policy :

    • Tonsillectomy

    • Grommets

    • Adenoids

    • Hysterectomy (unless malignant)

    • Pregnancy and childbirth

    • Joint replacement (unless accidental)

    • Hernia operations (unless an emergency.

    Premium

    R130.00 per individual or family per month.

Contact

Wellness Brokers

medical aid in-hospital gap evolution