Does health insurance cover my gynaecologist?


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health insurance

Does health insurance cover my gynaecologist? 

Health insurance & women's health - Specialist cover, gynaecologist visits and more. We dive into the benefits of health insurance for women’s health.

As we draw to the end of Women’s Month 2021, we thought we’d take some time to have a chat with the ladies. You deserve excellent healthcare and today, we’re here to show you how to get it.

As a woman, it’s so important to know what’s going on with your body. It’s a wonderful, powerful thing. Because we’re the ones with the capabilities to birth the children, we need specialist healthcare to make sure everything is in working order and that you’re safe and healthy.

This is the kicker: accessing that kind of healthcare is expensive. Necessary, but expensive. Gynaecologist visits, maternity care and medication are all routine costs that the average South African will struggle to afford without the help of health insurance.

And there’s the solution: health insurance. Not all health insurance policies will cover specialist visits, but we do with our exclusive Executive Healthcare Plan

Specialist cover

A specialist is an expert in a particular medical field. They have dedicated their studies to learn further about a certain area of medicine. If you have a target health issue, you couldn’t be in better hands.

If your doctor thinks there may be something that needs specialised care, they will recommend you to a specialist.

From there, they will be able to diagnose or treat you. Here are some examples of specialists (that are covered by our Executive Plan)

  • Oncologist
  • Cardiologist
  • Gynaecologist (who we’ll be talking about soon)
  • Orthopaedic
  • Neurologist

If your doctor wants to send you to a specialist, you shouldn’t need to worry about the hefty bill coming your way.

Read: How Preventive Healthcare Can Save Your Life & Your Money

Gynaecologist visits with Oneplan

Depending on your age and personal health history, you should be making an appointment with your gynaecologist once a year or once every two years. As your body changes your doctor will advise you if you need to go more often. You shouldn’t have to miss out on essential health checks just because you can’t afford them.

With the Executive Plan, you get up to R2 000 per visit and three visits per family per year. This way if you’ve already had your yearly check-up but your doctor refers you, you’re still covered for two more visits. Bear in mind you do need a doctor's referral to lodge a claim.

Take a look at some of the gynaecological procedures covered in your plan (after a 12 month waiting period):

  • Hysterectomies
  • CIN lesions
  • LLETZ (Large loop excision of the transformation zone)
  • Colposcopies
  • Endometriosis treatment
  • Ovarian cysts
  • Polycystic ovaries
  • Ablation of uterus
  • Fibroids
  • Hysteroscopies
  • Myomectomies

Plus a whole lot more. Some conditions you can claim for immediately after your three-month specialist waiting period. 

Please note that these prices are reflective of the date that this article was written. For up to date pricing, please follow this link.

Maternity cover

Of course, we also have an incredible range of maternity benefits should you decide to expand your family. . We have a range of pretty amazing benefits for the majority of our health insurance plans,, but we’ll focus on the Executive Plan for now.

You will have up to R2 520 in pre-birth cover which includes 4 specialist visits per pregnancy. When you give birth, you are covered for up to R70 000 (this falls under your casualty cover and is treated as a casualty event).

Please note that these prices are reflective of the date that this article was written. For up to date pricing, please follow this link.

That means you can give birth in a private hospital in the capable hands of excellent doctors, nurses and facilities. Are you more of a home-birth kind of gal? That’s cool, our benefits extend to at-home births as well.

Find out more about our impressive maternity benefits here.

Scripted medication cover

If you go to your gynaecologist and leave the appointment with a handful of scripts, you may be wondering why you even went in the first place. Let’s say you walk out with a script for antibiotics, probiotics and pain killers. That could easily cost you R800 (or more) out of pocket. But it doesn’t have to.

Oneplan covers you across the board for scripted medication. That means you don’t need to be a part of our Executive Plan, you could sign up for our Hospital Plan and still have access to scripted medication cover. 

Keep in mind that your limits (how much you are covered for) and benefits (what you’re covered for) are subject to your specific plan.

From us to you, we hope you’ve had an exceptional Women’s Month and continue to celebrate your strength, courage and the wonder of being a woman throughout the rest of the year. If you’re ready to join the Oneplan family, get in touch with somebody from our team here!


Yours in hassle-free health insurance designed with your health in mind,


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