Product Comparison
Product Option / Comparison
| Golden Hour | Hospital Plan | Comprehensive Standard | Primary Standard | Primary Standard With Hospital Plan | Comprehensive Advanced | |
|---|---|---|---|---|---|---|
| MAIN MEMBER PREMIUM PER MONTH | R210 | R245 | R420 | R455 | R540 | R1 025 |
| ADULT DEPENDANT PER MONTH | R125 | R155 | R280 | R395 | R350 | R795 |
| CHILD DEPENDANT PER MONTH | R50 | R70 | R190 | R165 | R225 | R355 |
| Benefits | ||||||
| Hospital Footprint | Access to all private hospitals accepting health insurance products. Pre-authorisation required. | Access to all private hospitals accepting health insurance products. Pre-authorisation required. | No benefit | Access to all private hospitals accepting health insurance products. Pre-authorisation required. | Access to all private hospitals accepting health insurance products. Pre-authorisation required. | Access to all private hospitals accepting health insurance products. Pre-authorisation required. |
| IN- HOSPITAL BENEFITS | ||||||
| In-hospital Maternity Benefit | No benefit | No benefit | No benefit | No benefit | No benefit | R35 000 per pregnancy for the birth. Limited to 1 event per policy every 12 months. Includes out-of-hospital scans. |
| In-hospital Accident Benefit | R225 000 per member per event, inclusive of all costs. Maximum of R1 000 000 per policy per annum. Pre-authorisation required. | R300 000 per member per event, inclusive of all costs. Maximum of R1 000 000 per policy per annum. Pre-authorisation required. | Sub-limit of R300 000 per member per event, inclusive of all costs, limited to R1 000 000 per policy per annum. Pre-authorisation required. | R100 000 per member per event, inclusive of all costs. Maximum of R 250 000 per member per annum and R 750 000 per policy per annum. Pre-authorisation required. | No benefit | R250 000 per member per event, inclusive of all costs. Maximum of R1 000 000 per policy per annum. Pre-authorisation required. |
| In-hospital Illness Benefit | No benefit |
R50 000 per member per event, inclusive of all costs. Conditions which have a gradual progression are excluded. Pre-authorisation required. Limited to R500 000 per policy per annum |
R50 000 per member per event, inclusive of all costs. Conditions which have a gradual progression are excluded. Pre-authorisation required. Limited to R500 000 per policy per annum |
R50 000 per member per event, inclusive of all costs. Conditions which have a gradual progression are excluded. Pre-authorisation required. Limited to R500 000 per policy per annum | No benefit | R100 000 per member per event, inclusive of all costs. Overall limit of R1 000 000 per policy per annum. Cataract Surgery is limited to R30 000 (thirty thousand Rand) per member per annum. Pre-authorisation required. |
| ICU Benefit | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | No benefit | Included in Hospital Benefits |
| Shortfall Benefit | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | No benefit | Included in Hospital Benefits |
| In-hospital Specialised Radiaolgy (MRI Scans, CT Scans etc) | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | Included in Hospital Benefits | No benefit | Included in Hospital Benefits |
| OUT-OF- HOSPITAL BENEFITS | ||||||
| Post-Hospital Accident Rehabilitation | R10 000 per member per event for physiotherapy and occupational therapy. Pre-authorisation required. | R10 000 per member per event for physiotherapy and occupational therapy. Pre-authorisation required. | R10 000 per member per event for physiotherapy and occupational therapy. Pre-authorisation required. | R5 000 per member per event for physiotherapy and occupational therapy. Pre-authorisation required. | No benefit | R10 000 per member per event for physiotherapy and occupational therapy. Pre-authorisation required. |