Say goodbye to expensive medical bills with PREPAID day-to-day claims to your Oneplan Claim Card in 1 minute. You can also request a refund for claims paid out of pocket via the Oneplan App.
We have put together a comprehensive guide to claiming on your Oneplan Health Insurance policy.
Simply click the button below to view and download our Oneplan Health Claiming Guide.
Can be used for GP or family doctor consultations, i.e. when you visit the doctor for a checkup or are triaged yellow or green in the emergency room.
Can be used for medication prescribed to you by a doctor that needs to be dispensed at a pharmacy, e.g. chronic medication, antibiotics. etc.
Can be used for any tests that require blood samples, e.g. blood sugar, cholesterol, etc. (Must be referred by a medical practitioner)
Can be used for non-prescription medication dispensed at a pharmacy, e.g. colds & flu medication, antihistamines, stomach flu remedies, etc.
Can be used for any tests that require x-ray imaging or radiology, e.g. broken/fractured bones, etc. (Must be referred by a medical practitioner)
Can be used for any non-aesthetic dental procedures or checkups, e.g. cleaning, fillings, etc.
Only available on the Executive Plan. Can be used if your GP refers you to a specialist for further treatment, e.g. ENT, oncologist, gastroenterologist, etc.
Can be used for consultations and scans during pregnancy. (Confirmation of pregnancy required and must be referred by a medical practitioner)
Can be used for eye exams, lenses, and frames. (Limited to 1 claim per 24 months per dependant)
Can be used in the event emergency treatments and procedures in casualty for unforeseen injuries that require immediate treatment and do not require overnight hospital stays, i.e. you visit the emergency room for an accident and are triaged red or orange.
Can be used in the event of emergency treatments for illnesses that do not require overnight hospital stays, i.e. you visit the emergency room for an illness and are triaged red or orange.
Can be used for a sudden, unexpected injury that requires immediate treatment and hospital admission, i.e. you are in a serious accident and must be admitted to hospital for treatment.
Can be used for an unforeseen disease or illness that requires hospital admission, i.e. you develop a serious illness and must be admitted to hospital for treatment.
Can be used in the event you develop a serious, life-threatening medical condition as outlined in our list of dread diseases, e.g. cancer, stroke, brain tumour, etc.
Can be used for the delivery of your new bundle of joy! Note that mom and baby are covered under the same benefit, and any birth/pregnancy complications are covered under this benefit.
Can be used if your newborn baby needs to be admitted to the neonatal specialist care unit at a hospital within 28 days after birth.
Your personalised Oneplan Claim Card will be delivered to your door 30 days after your first successful debit order. You need to download the Oneplan app, register, and after your 30-day waiting period, you can load day-to-day benefits in the app (under My Claims) to the Oneplan Claim Card in minutes. You can swipe this card like you would a debit card at your doctor after your consultation. (Subject to the applicable waiting periods.)
We make sure you can visit your preferred and trusted registered family doctor and/or hospital nationwide in South Africa. We also have contracts with all major hospitals, namely: Life, Mediclinic, and Netcare.
Oneplan is medical cover called health insurance which gives you access to private and government hospitals and offers broad day-to-day benefits such as X-rays,
Blood Tests, Pre-Birth Visits, Doctor Visits, Scripted and Over-the-Counter Medication, Dentistry, and Optometry cover,
at an affordable premium, to help you get better quickly when you need to.
Oneplan is under a special exemption from the Medical Schemes Act under demarcation and is regulated under the Short-Term Insurance Act and, therefore, is not a Medical Aid.
Oneplan sold its first health policy in 2010 and was created to ensure all South Africans have financial inclusion when it comes to affordable and sustainable healthcare.
There are general and specific exclusions, and conditions that apply to all our health plan types. These can be found in the policy wording and on our website sign-up journey.
Oneplan works a little differently when it comes to making sure you can get better quickly. You would use your day-to-day benefits for out-of-hospital cover. These have a per-event cover amount or invoice amount, whichever is lesser, as well as per-year cover limits. The day-to-day benefits have been tailored to ensure you have cover for Doctors’ Visits, Blood Tests, Medication, X-rays, Optometry, Dentistry, and Pre-Birth Maternity (depending on the plan you choose), ensuring that when the expected, unexpected and everything in between happens, you have the funds available to pre-load using the Oneplan App or via our Claims WhatsApp team.
Oneplan uses DebiCheck, to ensure our clients’ debit orders with us are safe, protected and permission controlled
Oneplan™ is administered by Oneplan Underwriting Managers (Pty) Ltd, an authorised financial services provider FSP43628. Oneplan is not a benefit option regulated by the Medical Schemes Act, but a short-term insurance product underwritten by Bryte Insurance Company Limited a licensed insurer and an authorised FSP (17703).