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Billionhbn Medical Insurance

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This is not a Medical Aid

Day-To-Day Benefits
Maximum Entry Age 65 years old

General Practitioners Consultations

Specialist Visit

  • Members must make use of CareCross General Practitioner
  • Unlimited Medically necessary Consultations
  • Specified Minor Trauma Treatment
  • Pre and Postnatal Care

- Supervision of uncomplicated pregnancy up to week 20

- Including two 2D sonar scans per pregnancy

Subject to the R1000.00 Out of Network benefit limit on referral by CareCross GP only.

The member will be required to pay for these services and submit the claim to CareCross for reimbursement.


Acute Medication

Chronic Medication

Acute Medication as dispensed by a CareCross General Practitioner or Medikredit pharmacy, according to a Medicine Formulary.

Registration and approval from the CareCross Clinical Department and according to a Medicine Formulary.

(SUBJECT TO A 3 MONTH WAITING PERIOD.)

Pathology



Radiology



Basic pathology - Basic blood tests as requested by a CareCross General Practitioner and subject to CareCross protocols and an approved list of codes.

Basic radiology - Basic X-Rays as requested by your CareCross General Practitioner and subject to CareCross protocols and an approved list of codes.

Basic Dentistry

 Members must make use of CareCross Dentists. Benefits include consultations, primary extractions, fillings, scaling and polishing.

Subject to a list of approved dental codes and CareCross protocols apply.

(SUBJECT TO A 3 MONTH WAITING PERIOD.)

Optometry (SUBJECT TO A 3 MONTH WAITING PERIOD.)



Members must make use of CareCross Optometrists.

One optical test per beneficiary per 24 months.

Qualifying norms for near and distance visions.

One pair of white standard mono-or bi-focal lenses in a standard frame.

CareCross protocols apply.

Registration Waiting Period

30 days after receipt of premium- inception date of policy on all benefits (unless otherwise stated) Maximum entry age 65 years old. Search the CareCross Network for A Registered Health Care professional.

Out of Network Visits

Limited to R1000 per family per annum.

The member will be required to pay for these services and submit the claim to CareCross for reimbursement from the R1000 per family per annum limit.

 

 

 

What you have to do to come back to this page. Bookmark this page by pressing Ctrl+D. After you had complete your application Click this Text to open up your email client then attach the form and sent it back to me. Altenatively you can olso click on the yellow envelope above next to my Cell number.

Accident Benefit

Accidental Disability

Up to R150 000 – Single person (R300 000 per family) per event.

R250 000 Principal Member only.

Single event (Permanent Disability Only)

Illness – Cash Benefit



Illness - Booster Benefit (R2000 Excess applicable)

In Hospital cash benefit: R6500 1st Day, R4500 2nd Day, R4500 3rd Day, R3000 4th Day, R3000 5Th Day, and thereafter R1500 per day up to a maximum of 21 days per member per illness event.

(90 DAY WAITING PERIOD ON ILLNESS) and 12 months waiting period on pre-existing conditions.

An additional illness protection benefit payable per annum up to R25 000 for a single member and up to R40 000 for a family, payable if the daily cash benefits are insufficient to cover hospital cost.

(90 DAY WAITING PERIOD AND SUBJECT TO PRE-AUTHORIZATION)

Specific Illness Benefit

Waiting Period

Appendectomy R30 000                   3 Months

Kidney Stones R30,000                   12 Months

Ectopic Pregnancy R20 000         12 Months

Hernia R15 000                                   12 Months

Gallbladder R35 000                         12 Months

Maternity R25 000                             12 Months

Hysterectomy R40 000                   24 Months

Dread Disease

(1 Incident per year per family.)

R9000 is payable per day upon diagnosis with 12 months an annual limit of R250 000 covering Heart Attack, Coronary Disease, Stroke, Brain Tumour, Cancer, Kidney Failure, Major Organ Transplant, Paraplegia and Blindness.

(90 DAY WAITING PERIOD)

24 Hour Emergency Service Powered by Africa Assist

Services include pre-authorization & arranging R10 000 guarantee admission in event of an accident.

Ambulance, Repatriation, Inter-Hospital transfer & 24 hour medical advice line.

Family Funeral Benefit

Principal, Spouse & Child >14yrs R10 000, > 6 yrs R5000, Child > 0 years R2500, Child > 28 weeks R1250 (90 DAY WAITING PERIOD) Underwritten by Assupol life.

Package Options

Day to Day Only


Hospital Only


Combined


Single

R321.00


R379.00


R579.00


Single + 1 Child

R463.00


R417.00


R731.00


Single + 2 Children

R613.00


R460.00


R878.00


Single + 3 Children


R764.00


R501.00


R1029.00


Single + 4 Children


R914.00


R544.00


R1191.00


Couple


R539.00


R739.00


R1108.00


Couple + 1 Child


R689.00


R781.00


R1266.00


Couple + 2 Children


R840.00


R825.00


R1418.00


Couple + 3 Children


R992.00


R866.00


R1564.00


Couple + 4 Children


R1141.00


R909.00

R1726.00

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