With Oneplan Gap Cover, you know exactly what you're covered for. There is no complicated jargon, confusing benefits, long claims processes or high monthly premiums. Just the GAP in health bills filled.
Double or quadruple scheme payout
Cover for all cancers, no questions asked
Even within your MSA Savings Threshold
At no extra premium
Plus add your child as a dependant from only R70pm.
The Savings Benefit will not be covered if insured belongs to a scheme Hospital Plan Only
30 days waiting period Once you have run out of your Scheme savings or if you have reached your day-to-day benefit sub-limit, we cover the shortfall for:
|
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Cover per policy* |
R2 000
per annum per policy (limited to R500 per event) |
Excluding penalties imposed by your Scheme
Immediately available for Accident 3-month waiting period for Illness We double (DBL) the Scheme approved settlement for all IN-HOSPITAL treatment and procedures which are above the scheme payout doubling what your Scheme pays. We will cover all specialists In-Hospital that would have been covered by the scheme. |
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Cover* |
Up to 200% of Scheme paid amount
(we double the Scheme settled amount) |
6-month waiting period
We double (DBL) the Scheme approved settlement for cancer related claims once the Medical Scheme’s oncology threshold has been reached. Your cover depends on the option you choose including co-payments, internal prosthetic devices and cancer treatment. |
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Cover* |
Up to 200% of Scheme paid amount
(we double the Scheme settled amount) |
Immediately available for Accident 3-month waiting period for Illness We pay any shortfalls or co-payments up to double the Scheme rate for a medical or surgical procedure following an emergency incurred in the casualty unit of a hospital where such costs were not met by the Scheme. Assesment will be based on the Triage Scale. |
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Cover* |
R5 000
per event per policy (limited to 2 events per annum) |
3-month waiting period for Illness
We pay any shortfalls or co-payments up to double the Scheme rate, subject to Cover Limit for diagnostic procedures authorised by your Scheme that is deemed necessary for treatment and diagnosis purposes performed in-hospital or a day clinic. Only 2 events per policy. |
---|
Cover* |
R5 000
per event per policy (limited to 2 events per annum) |
12-month waiting period
Any shortfalls that your scheme paid from your MSA for procedures such as pap smears, routine bloods, immunisation and IUDs. |
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Cover* |
R3 000
per annum per policy |
Testing Immediately available HIV Testing |
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Cover* |
R5 000 per policy |
Treatment Immediately available Treatment after Positive diagnosis. Must be reported within 48 hours. |
Cover* |
R10 000 per policy |
In the event that any Insured Person under this policy dies due to an unforeseen accident event
Immediately available We pay a lump sum cash amount in the unfortunate event of accidental death. |
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Cover per insured* |
|
Immediately available
Assistance with costs related to treatment for trauma, assault & counselling where accidental exposure to HIV or any other trauma occurs. |
---|
Cover per insured* |
R5 000 per policy |
The Savings Benefit will not be covered if insured belongs to
a scheme Hospital Plan Only
30 days waiting period Once you have run out of your Scheme savings or if you have reached your day-to-day benefit sub-limit, we cover the shortfall for:
|
---|
Cover per policy* |
R4 000
per annum per policy (limited to R750 per event) |
Excluding penalties imposed by your Scheme
Immediately available for Accident 3-month waiting period for Illness We quadruple (QDL) the Scheme approved settlement for all IN-HOSPITAL treatment and procedures which are above the scheme payout quadrupling what your Scheme pays. We will cover all specialists In-Hospital that would have been covered by the scheme. |
---|
Cover* |
Up to 400% of Scheme paid amount
(we quadruple the Scheme settled amount) |
6-month waiting period
We quadruple (QDL) the Scheme approved settlement for cancer related claims once the Medical Scheme’s oncology threshold has been reached. Your cover depends on the option you choose including co-payments, internal prosthetic devices and cancer treatment. |
---|
Cover* |
Up to 400% of Scheme paid amount
(we quadruple the Scheme settled amount) |
Immediately available for Accident
3-month waiting period for Illness We pay any shortfalls or co-payments up to quadruple what the scheme pays for a medical or surgical procedure following an emergency incurred in the casualty unit of a hospital where such costs were not met by the Scheme. Assessment will be based on the Triage Scale. |
---|
Cover* |
R7 000
per event per policy (limited to 2 events per annum) |
3-month waiting period for Illness
We pay any shortfalls or co-payments up to quadruple what the scheme pays, subject to Cover Limit for diagnostic procedures authorised by your Scheme that is deemed necessary for treatment and diagnosis purposes performed in-hospital or a day clinic. Only 2 events per policy. |
---|
Cover* |
R7 500
per event per policy (limited to 2 events per annum) |
12-month waiting period
Any shortfalls that your scheme paid from your MSA for procedures such as pap smears, routine bloods, immunisation and IUDs. |
---|
Cover* |
R5 000
per annum per policy |
Testing Immediately available HIV Testing |
---|
Cover* |
R5 000 per policy |
Treatment Immediately available Treatment after Positive diagnosis. Must be reported within 48 hours. |
Cover* |
R10 000 per policy |
In the event that any Insured Person under this policy dies due to an unforeseen accident event
Immediately available We pay a lump sum cash amount in the unfortunate event of accidental death. |
---|
Cover per insured* |
|
Immediately available
Assistance with costs related to treatment for trauma, assault & counselling where accidental exposure to HIV or any other trauma occurs. |
---|
Cover per insured* |
R5 000 per policy |
*Subject to Combined Annual Limit and Claim Limit. Terms and Conditions Apply. Pre-Existing Conditions are excluded
for a maximum of 12 Months if no previous Gap Cover.
Late Joiner Fees may be applied. Premiums are Risk Profile Age dependent.
Event incl multiple treatments or procedures, claimed 14days apart. Post-pregnancy benefit available for 6 months after delivery.