Hospital 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

R200 PM

Adult Dependent

R159 PM

Child Dependent

R69 PM

BENEFITS

In-Hospital Accident Benefit

R300 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

R50 000 per member per event. Not for conditions that develop over time. Limited to R500 000.

Maternity Benefit

No Benefit

Casualty Benefit for Accidents

R30 000 per policy.

Casualty Benefit for Illness

No Benefit

General Practitioner visits (GP/ doctor)

No Benefit

 
 

Out-of-Network General Practitioner visits (GP)

No Benefit

 
 

In-Room Procedures

No Benefit

 
 

Pharmacy Clinic Nurse Care

No Benefit

 
 

Specialist Benefit

No Benefit

 
 

Acute Medication

No Benefit

 
 

Over-the-Counter Medication (OTC)

No Benefit

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.