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.
|
Core Plan
From
R220
|
Executive Plan
From
R285
|
||
|---|---|---|---|
| x | x |
R210 000 Per Insured |
R210 000 Per Insured |
| Outpatient Cover | Cover Description | Cover Per Policy* | |
|
SAVINGS GAP COVER
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:
|
R2 000 per annum per policy (limited to R500 per event) |
R4 000
per annum per policy (limited to R750 per event) |
| In-hospital & specialised treatment | Cover description | Cover* | |
|
SHORTFALLS & CO-PAYMENTS
FOR ALL IN-HOSPITAL TREATMENT
AND PROCEDURES
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. 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. 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. |
Up to 200% of Scheme paid
amount
(we double the Scheme settled amount) |
Up to 400% of Scheme paid
amount
(we quadruple the Scheme settled amount) |
|
CANCER CO-PAYMENT BENEFIT
6-month waiting period |
Up to 200% of Scheme paid
amount
(we double the Scheme settled amount) |
Up to 400% of Scheme paid
amount
(we quadruple the Scheme settled amount) |
|
|
CASUALTY ACCIDENT/ILLNESS
Immediately available for Accident 3-month waiting period for Illness |
R5 000 per event per policy (limited to 2 events per annum) |
R7 000
per event per policy (limited to 2 events per annum) |
|
|
SCANS & SCOPES (SPECIALISED RADIOLOGY) 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.
Any shortfalls that your scheme paid from your MSA for procedures such as pap smears, routine bloods, immunisation and IUDs. HIV Testing Treatment after Positive diagnosis. Must be reported within 48 hours |
R5 000
per event per policy (limited to 2 events per annum) |
R7 500
per event per policy (limited to 2 events per annum) |
|
POST PREGNANCY COVER
12-month waiting period |
R3 000 per annum per policy |
R5 000 per annum per policy |
|
|
ACCIDENTAL HIV INFECTION
& TREATMENT
Testing Immediately available Treatment Immediately available |
R5 000 per policy
R10 000 per policy |
R5 000 per policy
R10 000 per policy |
|
| Value Added Products | Cover Description | Cover Per Insured* | |
|
ACCIDENTAL DEATH
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. |
Principal: R10 000 Spouse / Partner: R10 000 Children 14 - 21 yrs: R10 000 Children 6 - 13 yrs: R7 500 Children 1 - 5 yrs: R5 000 |
Principal: R25 000 Spouse / Partner: R25 000 Children 14 - 21 yrs: R25 000 Children 6 - 13 yrs: R15 500 Children 1 - 5 yrs: R10 000 |
|
TRAUMA, ASSAULT & COUNSELLING
Immediately available |
Assistance with costs related to treatment for trauma, Assault & counselling where accidental exposure to HIV or any other trauma occurs. |
R5 000 per policy |
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.
SAVINGS GAP COVER
R2 000
per annum per policy
(limited to R500 per event)
30 days waiting period
SHORTFALLS & CO-PAYMENTS
FOR ALL IN-HOSPITAL
TREATMENT AND PROCEDURES
Up to 200% of Scheme Rate
(we double the Scheme Rate)
Excluding Penalties Imposed By Your Scheme
Immediately Available For Accident
3-Month Waiting Period For Illness
CANCER CO-PAYMENT BENEFIT
Up to 200% of Scheme paid
amount
(we double the Scheme
settled amount)
6-month waiting period
CASUALTY ACCIDENT/ILLNESS
R5 000
per event per policy
(limited to 2 events per annum)
Immediately available for Accident
3-month waiting period for Illness
SCANS & SCOPES
(SPECIALISED RADIOLOGY)
R5 000
per event per policy
(limited to 2 events per annum)
3-month waiting period for Illness
POST PREGNANCY COVER
R3 000
per annum per policy
12-month waiting period
ACCIDENTAL HIV INFECTION
& TREATMENT
R5 000
per policy
Testing Immediately available
R10 000 per policy
Treatment Immediately available
ACCIDENTAL DEATH
Principal: R10 000
Spouse / Partner: R10 000
Children 14 - 21 yrs: R10 000
Children 6 - 13 yrs: R7 500
Children 1 - 5 yrs: R5 000
Immediately Available
TRAUMA, ASSAULT &
COUNSELLING
R5 000
per policy
Immediately Available
SAVINGS GAP COVER
R4 000
per annum per policy
(limited to R750 per event)
30 days waiting period
SHORTFALLS & CO-PAYMENTS
FOR ALL IN-HOSPITAL
TREATMENT AND PROCEDURES
Up to 400% of Scheme paid
amount
(we quadruple the Scheme
settled amount)
Excluding Penalties Imposed By Your Scheme
Immediately Available For Accident
3-Month Waiting Period For Illness
CANCER CO-PAYMENT BENEFIT
Up to 400% of Scheme paid
amount
(we quadruple the Scheme
settled amount)
6-month waiting period
CASUALTY ACCIDENT/ILLNESS
R7 000
per event per policy
(limited to 2 events per annum)
Immediately available for Accident
3-month waiting period for Illness
SCANS & SCOPES
(SPECIALISED RADIOLOGY)
R7 500
per event per policy
(limited to 2 events per annum)
Immediately available for Accident
3-month waiting period for Illness
POST PREGNANCY COVER
R5 000
per annum per policy
12-month waiting period
ACCIDENTAL HIV INFECTION
& TREATMENT
R5 000
per policy
Testing Immediately available
R10 000 per policy
Treatment Immediately available
ACCIDENTAL DEATH
Principal: R25 000
Spouse / Partner: R25 000
Children 14 - 21 yrs: R25 000
Children 6 - 13 yrs: R15 000
Children 1 - 5 yrs: R10 000
Immediately Available
TRAUMA, ASSAULT &
COUNSELLING
R5 000
per policy
Immediately Available
*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.
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).
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