When you jump onto any health insurance policy, you need to know what’s cracking. Let’s explore all the ins and outs of emergency casualty cover for accident and illness.
Health insurance is split up into separate types of cover to help organise different plans and figure out how to divide your limits up between various health-related situations. Some of these cover groups include routine care cover, specialist cover and, what we’re going to be talking about today, emergency casualty cover.
In a nutshell, emergency casualty cover is cover for the unexpected. For the things that you definitely didn’t see coming, but the things that you need immediate medical attention for.
What makes up emergency casualty cover?
Two things fall under casualty cover: accident casualty and illness casualty. A casualty is an emergency incident that requires immediate medical attention — meaning you can’t wait for a doctor’s consult and need to get to the hospital or emergency room right away. Obviously, the last thing you want to be thinking about when things go pear-shaped is “jeepers, how am I going to afford this?”
And that’s why you get health insurance.
Emergency casualty cover is for incidents that require immediate medical attention but do not require you to stay overnight in the hospital. If you head into the hospital for an emergency, your doctor will use something called a “triage category” to determine whether your incident classifies as a casualty. The Triage Category process is outlined to help doctors and insurers categorise incidents in terms of emergency timeframe. How quickly does this patient need to be seen?
Read more: What is covered in health insurance?
Triage category and cover
Green: 4 hours. If you have been given the green code, that means you will initially qualify for general cover for a GP consult. Emergency cover will depend on your diagnosis after treatment.
Yellow: 1 hour. This emergency will not fall under emergency cover. Instead, it will fall under general health cover and you will visit a GP, radiologist, pathologist or the x-ray team.
Orange: 10 minutes. This will fall under emergency casualty cover.
Red: Immediate. This will fall under emergency casualty cover.
The truth of the matter is that people fall ill and people get into harmful accidents, and the costs to bring them back to good health are usually pretty steep. If you don’t have health insurance, that is.
Having emergency casualty cover means that when you have an accident or fall ill, you will have the financial support to receive treatment in a private hospital (the only hospital you really want to be in, right?)
Read this next: Why are second medical opinions so important?
The difference between injury and illness
What is illness casualty cover?
Illness casualty cover refers to most things that happen in the emergency room of a hospital.
Any emergency treatment you need for an illness that does not require an overnight stay will be covered with illness casualty cover. Keep in mind that this cover has a 90-day waiting period, meaning you’ll need to wait 3 months from the inception of your policy before you claim.
What is accident casualty cover?
Accident casualty cover is for when you sustain injuries that require emergency treatment or procedure immediately. This treatment will be triaged as either red or orange, meaning you need treatment within the next hour to prevent permanent damage.
Accident cover has zero waiting period, so you can claim for accidents from the moment you join your policy.
Related: 5 Things You Need to Know Before You Compare Health Insurance Plans
Casualty cover with Oneplan
Please note that these prices are reflective of the date that this article was written. For up-to-date pricing, please follow this link.
Our health plans are all designed to give you as much as possible for what you’re paying. Take a look at the plans we have on offer and how much casualty cover is included in each one (you can tap on the links to find out more about each plan!)
Core & Core Plus Plan: From R500pm
- Casualty Illness Cover: R5800
- Casualty Accident Cover: R5800
Blue Plan: R1000pm
- Casualty Illness Cover: R5800
- Casualty Accident Cover: R5800
- (The casualty cover on this plan may be the same as our Core and Core Plus Plans, but the Blue Plan is where you start seeing higher routine care benefits for things like visits to the doctor and maternity care)
Professional Plan: R1465pm
- Casualty Illness Cover: R6000
- Casualty Accident Cover: R6000
Executive Plan: R1975pm
- Casualty Illness Cover: R6200
- Casualty Accident Cover: R6200
At the end of the day, we want you to be covered regardless of what you’re paying in premiums. Health emergencies happen out of the blue, and you want to be prepared for when they do. Get emergency casualty cover plus more – get a quote.
Your Health Insurance Family,
Oneplan
