Rates above are for Individuals, per member per month. If you are a member as part of a Group/ Company, your rate may be different.
In-Hospital Accident Benefit
R250 000 per member per event. Maximum of R1 000 000.
Access to all private hospitals accepting health insurance products.
Included in Hospital Illness Benefits.
Included in Hospital Illness Benefits.
R10 000 per member per event for physiotherapy and occupational therapy only.
In-Hospital Illness Benefit
R100 000 per member per event. Overall limit of R1 000 000. Cataract Surgery is limited to R30 000 per member.
R35 000 for birth. Limited to 1 event every 12 months. Includes 2 out-of-hospital ultra-sounds.
Casualty Benefit (Accident)
R10 000 per policy.
R6 000 for after-hours treatment only.
Managed unlimited GP consultations at a network doctor.
Out-of-Network General Practitioner visits (GP)
2 consultations refunded at R450 per visit.
Defined list of procedures a network GP can perform in their rooms at no additional charge.
Pharmacy Clinic Nurse Care
Unlimited care for a defined list of procedures available from nurses at Mediscor pharmacies with contracted clinics.
R2 500 per member. Referral by network GP required. Members must pay cash and claim from Wesmart.
Unlimited Acute Medication available only from a Mediscor pharmacies. Subject to Formulary.
Over-the-Counter Medication (OTC)
R200 per month. R800 per year. Subject to Formulary.
Unlimited. Approval must be obtained from Chroniline. Chronic Medication may be obtained from a Mediscor pharmacy or from a Network Dispensing Doctor. Subject to Formulary.
Unlimited Black and white x-rays only. Members must be referred by a network GP.
Unlimited blood tests according to our list of tests. Members must be referred by a network GP.
Basic dentistry only. Treatment available based on Wesmart‘s Protocols and limits.
Only available at Specsavers branches. 1 consultation, 1 set of frames with single vision lenses per member, every 24 months. Maximum of R1 375.
At Wesmart, we have strong relationships with all the private hospitals. Our largest shareholder owns Africa Health Care.
Follow this link to find an Africa Health Care hospital near you:
Pre-Authorisation is required for all hospital admissions on 010 599 1172.
Value Added Benefits
24-hour Emergency Medical Services
Personal Health Advisor
Clinically trained Personal Health Advisor available for telephonic consultations and advice, including Trauma Councelling, Health Information, Chronic condition management, general Health advice.
Accidental Death Benefit
Principal: R15 000
Adult Dependant: R10 000
Child Dependant: R8 000
Pharmacy Clinic Nurse-Based Care
Care from qualified nurses at over 700 pharmacy Wellness Clinics. Visit them in store at your convenience or book an appointment for a consultation. Nurses will give you a medical referral if necessary. Available at all Mediscor Pharmacies with contracted Clinics.
• General Member Wellness
• Women’s Health
• Assistance Managing Chronic Conditions
General Member Wellness
• Glucose and Cholesterol screening / testing / monitoring.
• Treatment of wounds.
• Administration of injections, including annual flu injection.
• Hb, Malaria and Urine Screening.
• Syringing of ears.
• Advice on how to best manage your status and health.
Caring advice women can rely on, offering all types of female health assessments such as
pregnancy testing, breast screening, pap smear testing and other female screenings.
Assistance Managing Chronic Conditions
Nurses will help you manage your chronic condition and assist you with monitoring and
advice, including but not limited to:
• Diabetes Hba1C and foot screening.
• Blood pressure and lipogram testing, BMI monitoring.
• Peak flow and nebulization. Control asthma by getting rescue medication
directly into the lungs.
• HIV screening, testing and counselling: Learn your HIV status and get psycho
logical help after testing positive. A counselling session is offered pre-testing