Does Health Insurance Cover Regular Doctor Visits?


Jade Poole

Does Health Insurance Cover Regular Doctor Visits

You might think that health insurance coverage is limited to only hospital claims, but we’re here to tell you that there’s so much more to health insurance than you may realise. Here’s what you need to know about health insurance and doctor visits. 

So, you think health insurance is nothing more than a simple hospital plan? That’s okay. You’re not alone. In fact, we get that all the time of our clients. 

The great news is that our healthcare cover is SO MUCH MORE than just a hospital plan. 

If you’ve done a little digging into what health insurance is and how to choose a healthcare plan, then you might have a basic idea of what this form of health cover offers you. But to make your life a little easier, which is something we love to do, we have outlined everything you need to know about health insurance and day-to-day cover in this article

Tell me a little bit more about health insurance and how it works

Health insurance is something that is incredibly important to have as it helps you pay for a number of private healthcare costs ranging from routine care doctor visits and major medical bills associated with serious injury or illness. 

In exchange for a monthly fee, known as your premium, your health insurance gives you instant access to private healthcare and helps protect you from both expected and unexpected medical costs. 

But wait, is health insurance the same thing as medical aid? 

Health Insurance Cover

This is another question we get asked quite often. The simple answer is: No. Health insurance is NOT the same thing as medical aid

Whilst both these forms of healthcare coverage give you access to private healthcare and help you pay for expensive medical bills, health insurance outlines limits to your benefits. This means you know exactly how much coverage you get for each benefit. For example, for accidents, depending on your chosen plan, you will know the exact amount we will cover in the event of a claim. 

Medical aid, on the other hand, is required by law to pay for what could be some very expensive procedures classified under PMBs (Prescribed Minimum Benefits).

“Prescribed Minimum Benefits (PMBs) is a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.” According to the Council of Medical Schemes.

Medical aids also have to provide you with specialist and in-hospital cover determined by specific tariffs.

The bottom line: health insurance is the affordable alternative to medical aid. Giving you the same access to private healthcare but at a fraction of the cost. 

Does medical insurance cover regular doctor visits?

We certainly do! 

Each one of our healthcare plans includes cover for routine care costs. 

Am I limited to a specified network of doctors?

Certainly not! 

At Oneplan, instead of limiting you to a specified network of doctors, we let you go to any doctor of your choice

How does claiming work for doctor visits?

Not only do we let you go to any doctor of your choice, but we also front you with the cash you need to see the doctor BEFORE your visit. 

We do this using our unique Onecard. 

Before you need to visit your doctor, simply log into the Oneplan App, preload your claim and we will transfer the funds to your Onecard. This Onecard is sent to you when you become a member of our Oneplan family. You will use this card the same way you would a debit card. Simply swipe it at your doctor’s office and just like that, we help take care of the bill. 

Of course, the exact amount of cover you have will be based on your chosen plan. 

Day-to-day benefits according to our healthcare plans

At Oneplan, we have a wide range of day-to-day benefits included in all of our healthcare plans. All of our plans were made to suit a wide range of budgets and healthcare needs. 

Here are some of the day-to-day benefits you can find in our health insurance plans: 

  1. General Practitioner (Doctor)

  2. Scripted Medication

  3. Pathology (blood tests)

  4. Radiology (x-rays)

  5. Dentistry

  6. Maternity Pre Birth

  7. Optometry

  8. Specialist Cover (on our top plan)

Team of nurses to chat with

Did we mention we also have a team of nurses who form part of our claims team for you to chat with about any health questions you may have? 

Instant access to your policy

Thanks to our smart and simple Oneplan App, you have instant access to your policy details from the palm of your hand. Our app also lets you chat with a team member if you have any questions or concerns. 

Yours in quality health insurance


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