DOCSURE SIMUNYE

The Entry Level Solution

Overall Annual Limit

R500 000

Individual Premium

R837

Family of 3 Premium

R1 317

Family of 5 Premium

R1 528

Docsure Simunye Benefits

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Pre-Authorisation Required.  Please call 010 599 1172.

Hospital Footprint 
National Private / State facilitated by Africa Assist.

Maternity Benefit 
A sub-limit of R15 000 per policy per annum for confinement, includes 2 Pre-natal consultations refunded at R700 each at a private facility only.

Illness Benefit Includes All Ward Fee Structures
Day 1:
R4 800
Day 2: R4 000
Day 3-6: R3 000
Day 7 Onwards: R1 750 per day to a limit of R22 500 per event.

Hospital Booster
A sub-limit of R10 000. Paid out at R1 250 per day. Limited to 2 events per annum.

Treating And Admitting Practitioners
Maximum of R5 000 per event for treating and admitting practitioners.

Anaesthetic Benefit
Maximum of R3 000 per event for anaesthetic practitioners.

Radiology and Pathology (In and out of hospital)
A maximum of R5 000 per policy per annum for specialised radiology in hospital only. R3 000 for all Pathology tests in hospital only and Black and White X-Rays out of hospital only, limited to R1 500 per policy per annum. R850 excess per Specialised Radiology scan and R200 excess for blood tests.

GP Consultations
8 consultations for an individual, 12 consultations for a family of 3 and 15 consultations for a family of 5, provided the Designated Network is used. Dispensing GP reimbursement paid at R330 per consultation and non-dispensing GP reimbursement paid at R300 per consultation.

Specialist Visits
Individual Option:
1 Consultation refunded at R700.
Family Option 3:2 consultations refunded at R700.
Family Option 5:3 consultations refunded at R700.

Acute Medication
Individual Option: R800.
Family Option 3: R1 500.
Family Option 5: Limited to R2 200 per policy per annum. Up to a maximum of R180 per script.

Chronic Medication (Per CDL)
Individual Option: R1 250.
Family Option 3: R2 150.
Family Option 5: Limited to R3 250 per policy per annum. Up to a maximum of R230 per script.

Basic Dentistry
R600 as a combined benefit for consultations, Fillings, X-Rays and Extractions, including Scale and Polish, 2 Emergency Root Canal at R400 each, 2 Crowns at R500 each and in chair Wisdom Teeth at R750, per beneficiary per annum.

Optometry
All activities for Optometry Services including (Eye Test, 1 Consultation, Frames and Lenses up to R900) or Contact Lenses up to R900 every 24 months per beneficiary.

HIV Early Detection
HIV Elisa blood test. Pre and Post testing for HIV. Symptomatic treatment due to HIV infection. Medicines available through state only.



Personal Health Advisor

Clinically trained consultant available 24/7.

 

 

Legal Compliance

Wesmart Financial and Administration Solutions (Pty) Ltd is an authorised Financial Services Provider (FSP: 45769) Underwriting Agency for GENRIC Insurance Company Limited (FSP: 43638). GENRIC is an authorised Financial Services Provider and registered Short-term insurer.

Contact Info

Tel: 010 599 1170

Email: info@wesmart.co.za

Address: Building 3, Midrand Business Park, 563 Old Pretoria Main Road, Midrand, Gauteng