Comprehensive Advanced Plan
Home / Plan Details
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.