Senior Comprehensive Plan

The Senior Comprehensive Plan is a Day1 Health senior option that combines day-to-day and hospital-related benefit categories.

Plan overview

The Senior Comprehensive Plan is a Day1 Health senior option that combines day-to-day and hospital-related benefit categories.

Who this plan may suit

Consider this plan type when you are comparing senior options that combine everyday healthcare support and hospital-related benefits.

Key benefit categories

The following categories may be available under this plan. Read the relevant plan document for full details, limits, exclusions and eligibility requirements.

Network doctor consultations and selected day-to-day services
Acute and chronic medication support, subject to plan rules
In-hospital illness and accident benefit categories
Funeral benefit

Detailed benefit card information

These benefit-card details are provided for plan comparison. Read the relevant plan document before applying, as benefits, limits, exclusions, waiting periods and terms apply.

Private Managed Doctor Visits: Consultations available via a registered Day1 Health Network Partner. Limited to 5 doctor visits per member per annum. Pre-authorisation is required. A 1 month waiting period applies.
Pathology: Basic diagnostic blood tests on referral by a 1Doctor Health Network GP and subject to a list of basic pathology tests approved by Day1 Health. A 1 month waiting period applies.
Acute Medication: Acute medication covered according to the 1Doctor Health formulary. A 1 month waiting period applies.
Basic Dentistry: Preventative cleaning, fillings, extractions and emergency pain and sepsis control via a Day1 Health Network Dentist. Two visits per member per annum. Pre-authorisation is required for each visit. A 3 month waiting period applies.
Chronic Medication: Chronic medication is covered according to the 1Doctor Health formulary. A 3 month waiting period applies for unknown conditions and a 12 month waiting period for pre-existing conditions. Pre-authorisation applies. An additional administration fee may be levied on approved chronic medication.
Optometry (Iso Leso Optics): One eye test and one set of glasses every 24 months in the specific Iso Leso Optics agreed protocol range. A 12 month waiting period applies.
Radiology: Basic radiology according to the 1Doctor Health formulary via a 1Doctor Health network GP. Black-and-white diagnostic X-rays only. A 1 month waiting period applies.
Out-of-Area Visits: If you cannot see your network GP, the plan allows 3 out-of-area visits per family per annum to an alternative network GP or GP of your choice, subject to pre-authorisation. A 1 month waiting period applies.
In-hospital Illness Benefit: Covers up to R 10 000 after the first 24 hours in hospital, up to R 10 000 for the second day in hospital and up to R 10 000 for the third day in hospital. Thereafter R 1 500 per day up to a maximum of 21 days. A 3 month waiting period applies and a 12 month pre-existing conditions exclusion applies.
1st Day in Hospital: Up to R 10 000.00 — not less than 24 hours from time of admission to time of discharge.
2nd Day in Hospital: Up to R 10 000.00.
3rd Day in Hospital: Up to R 10 000.00.
Every subsequent day thereafter: R 1 500
Maximum Benefit payable for 21 day period: Up To R 57 000.00
24 Hour Emergency Services ambulance & Pre-Authorisation: 24 hour emergency services and pre-authorisation provided by Africa Assist, including 24 hour medical advice and access to unlimited pay-as-you-go virtual doctor consultations. Immediate cover.
Accident/Trauma Benefit (Exclusion: Sports injuries): Up to R75 000 per single member and up to R150 000 per family incident. Immediate cover, limited to two events per annum. Sports injuries are excluded.
Funeral Benefit: Principal member and spouse R5 000. A 3 month waiting period applies. Benefit is available to plan members.

Important plan conditions

Benefits, limits, exclusions, waiting periods and terms may apply.
Some benefits may require use of a network provider, referral or pre-authorisation.
Benefit availability is subject to the applicable plan rules and supporting documents.
Request a quote and review the relevant documentation before applying.

Compare plan categories and tiers before choosing the option that best matches your healthcare needs.