Golden Hour 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
R165 PM
Adult Dependent
R122 PM
Child Dependent
R53 PM
BENEFITS
In-Hospital Accident Benefit
R225 000 per member per event. Maximum of R1 000 000.
Hospital Footprint
Access to all private hospitals accepting health insurance products.
ICU Benefit
Included in Hospital Benefits.
Shortfall Benefit
Included in Hospital Benefits.
Post-Hospital Accident Rehabilitation
R10 000 per member per event for physiotherapy and occupational therapy only.
In-Hospital Illness Benefit
No Benefit.
Maternity Benefit
No Benefit
Casualty Benefit for Accidents
R30 000 per policy.
Casualty Benefit for Illness
R15 000 in the event of stabilisation of an Emergency Illness per member.
General Practitioner visits (GP/ doctor)
2 GP consultations at a contracted network doctor per member.
Out-of-Network General Practitioner visits (GP)
No Benefit
In-Room Procedures
Defined list of procedures a network GP can perform in their rooms at no additional charge.
Pharmacy Clinic Nurse Care
3 visits per member for a defined list of procedures available from nurses at Mediscor.
pharmacies with contracted clinics.
Specialist Benefit
No Benefit
Acute Medication
R1 500 per member. Max R190 per script. Combined with OTC benefit. Subject to Formulary.
Over-the-Counter Medication (OTC)
Combined with in Acute Medicine Limit.
Chronic Medication
No Benefit
Radiology
No Benefit
Pathology
No Benefit
Dentistry
No Benefit
Optometry
No Benefit
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 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 (24/7)
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
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.
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.