Comprehensive Advanced Plan

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Monthly Premiums

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.

Principal

R950 PM

Adult Dependent

R765 PM

Child Dependent

R345 PM

BENEFITS

Accident Cover

R250 000 per person per event,
limited to R1 000 000 per policy per
annum

Illness Benefit

DAY 1: R10 000
DAY 2: R7 500
DAY 3: R5 500

DAY 4 Onwards: R3 500 per day. Limited to 21 days admission, including all costs. Contract Surgery is limited to R30 000 per member per annum

 
 

ICU Benefit: for Illness only

R15 000 per day

Shortfall Benefit

R30 000 per policy per annum and is
available if sub-limits are reached

Post-Accident Rehabilitation

R10 000 per member per event

Emergency Stabilisation

No Benefit

In-hospital Maternity Benefit

Up to R35 000 per pregnancy

Casualty Benefit for Accidents

R10 000 per accident event and
accumulates to overall Accident
Cover limit, irrespective of admission

 
 

Casualty Benefit for Illness

R6,000 per policy per annum

GP Consultations

Unlimited

 
 

Out-of-Network Consultations

2 visits per policy per annum
refunded at R400

 
 

In-Room Procedures

Included

 
 

Pharmacy Clinic Nurse Care

Unlimited visits. Pre-authorisation
required after 10th visit.

 
 

Specialist Consultations

R2 500 per member per annum

 
 

Acute Medication

Unlimited

 
 

Over-the-Counter Medication (OTC)

R200 per policy per month, limited to
R800 per policy per annum

Chronic Medication

Unlimited

Radiology

Unlimited

Pathology

Unlimited

Dentistry

Unlimited

Optometry

1 consultation, one set of frames with
single vision lenses. Cover is available
for members every
24 months.

ADDITIONAL BENEFITS

Hospital Footprint

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:
https://www. africahealthcare.co.za/find-a-hospital/.
Pre-Authorisation is required required for all hospital admissions on 010 599 1172.

Value Added Benefits
24-hour Emergency Medical Services

24-hour cover for private ambulances and emergency medical evacuation in the event of
emergencies. Pre-authorisation required (not available on the Primary Standard Option)

Personal Health Advisor

Telephonic consultations with clinically trained Personal Health Advisors available 24/7.
You can call them for trauma counselling, general medical advise, Covid advice or any
ailments or concerns you may have about your health.

Accidental Death Benefit

A lump sum payout in the event of the death of a member.

Pharmacy Clinic Nurse-Based Care
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 contracted Mediscor Pharmacies, including Dischem Clicks, Medirite etc.
Pre- authorisation is required after 10th visit.

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.

Women's 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
as well.