4 questions about your health insurance, answered


Because we make health insurance simple, we run you through 4 things that help you to understand your policy

Health insurance is one of those things you can’t live without, and shouldn’t have to. Simply because you never know what could happen in the future.

State owned hospitals are just not reliable and could lead to you waiting in lines for hours until a doctor can tend to you, no matter how big of a medical emergency you may be suffering from.

This is not to say that all government hospitals are like this, but it is not worth taking the chance.

Health insurance gives you the peace of mind you need and helps you to live a long, happy and healthy life.

Being the affordable alternative to medical aid, we help cover the costs of private healthcare.

Doctors, medication and hospitals can cost you a whole heap of money. Money that a lot of us often don’t have right now and we certainly don’t want to put ourselves in debt just by going to the doctor.

Here are 4 things we want you to know about your health insurance to help you to understand your cover just a little better:

1. What medications am I covered for?

We cover a wide range of prescription medications, if there is anything you are uncertain of in terms of what you are covered for, then just give us a shout….


What you are covered for:

●         Prescribed medication

●         Baby and child immunisations

●         Flu vaccinations

●         Chronic (ongoing) medication (including ARVs) (if the conditions were diagnosed after the waiting period)

●         Doctors who give you the medication themselves


What you are NOT covered for:

●         Over the counter medications

●         Chronic medication for pre-existing conditions, including HIV (diagnosed before your policy started or within the first 3 months)

●         Contraceptives

●         Vaccinations for travelling

●         Medication for impotence, infertility, acne

●         Stimulants, tonics, supplements

●         Medication related to general exclusions (things we don’t cover) - e.g. mental illness and learning problems


2. Which doctors and hospitals can I visit?

Most health insurance providers have a network of hospitals and general practitioners you can visit.

But here’s what makes us different…

We don’t believe that you should have to give up your family doctor just because you signed onto a new health insurance.

We let you got to any doctor or hospital you choose.

The best part?

We also pay you BEFORE you see the doctor.

All you have to do is upload your claim amount through the Oneplan App on your phone and we will transfer the funds to you within minutes.

We also cover optometrist and dentist visits.

3. Am I covered for pre-existing conditions?

What’s a pre-existing condition?

Any sickness or condition that you have already been diagnosed with or have signs of before your policy starts or within 3 months after it started.

A condition will still be seen as pre-existing even if you were not aware of it but show symptoms.

We need to know about pre-existing conditions before we cover you for health insurance.

Pre-existing conditions are not covered for the first 12 months of your policy.

This does not mean that you should not get health insurance because serious conditions are life-long and when your cover kicks in, we will help you to cover the costs of doctor visits and other various medical bills.

Excluded conditions mentioned in your Policy Wording Doc - These include ulcers, tonsillectomy and kidney stones

4. Which procedures am I covered for?

You never know what could happen and there’s no way to tell what procedures you may need in the future.

Everything you need to know about what procedures you are covered for are outlined in your policy wording doc.

We cover a number of treatments and procedures that require hospital admission such as birth, Heart attack, Coronary artery disease requiring surgery, Heart valve replacement, Surgery to the aorta/aneurysm, Stroke, Cancer, Major organ transplant, Brain tumours.

There are of course some things we don’t cover like self-inflicted injuries, sports injuries and others all outlines in your policy document.


We like to make sure that our insurance is easy to understand and simple to use. That’s why we also have a team available to answer any questions you may have through the App or our call centre.

It is our goal to make sure that you know exactly what you are covered for and what you are not.

Yours in health,


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