Corporate Plan


Overview


Compare Plan Benefits

We offer you a diverse range of corporate plans available in three categories; Gold, Silver & Bronze catering for your specific healthcare and financial needs.

Our plans are a hybrid component of the low claims account and insured benefit. Member benefits are per membership year, they are effective the date the member/ beneficiary joins the . These benefits are paid up to an annual global limit.

  • Topaz
  • Coral
  • Ruby
  • Amber
  • Sapphire
  • Sapphire Plus
  • Opal

Gold

The benefits and contributions track movement in inflation in order to ensure benefits do not lag behind market dynamics. Members on the Gold Category generally do not encounter shortfalls.

Silver

This is a hybrid of inflation adjusted and static contributions on the standard category. This plan can be customised to address an organisation’s specific needs.

Bronze

The standard category is suitable for clients who wish to keep their medical aid contributions at a fixed and predictable level and benefits are also adjusted less often.  Due to the volatile economic environment, members may encounter shortfalls. However, our team mitigates shortfalls through the establishment of in-house services and partnerships with specific service providers

Benefits

Medical Benefits

All plans ensure members get cover for essential health care at government and private facilities. These include; Hospitalisation, Drugs, Pathology, Specialised Radiology, Dental, Optical, Pathology & Rehabilitative Services

Managed Care

This is a support structure for members with chronic conditions, support is in the form of SMS’s, calls, hospital visits and drug facility access. The drug facility is designed to help members access the chronic drugs easily in conjunction with partner pharmacies located across the country.

Immediate Benefits

Corporate accounts with 10-49 members from inception enjoy immediate access to General Practitioners and Pharmacies without any waiting periods. Corporates with over 50 members from inception enjoy further immediate cover for admission or treatment at a hospital, MRI, CT Scans and nuclear medicine.

Value Added Benefits

Over and above the medical cover, members get the following benefits:

  • Low Claims Account Cash Back
  • Free Funeral Cover
  • Free Life-med Guarantor Cover
  • 1st Care Wellness Benefits
  •  

General Waiting Periods

Subject to waiver at the Fund-s discretion, the following benefits have waiting periods. Waiting periods are imposed on members joining the fund for the first time or with a lapse on membership. Waivers may be granted to members transferring from an AHFoZ affiliated Medical Aid business upon presentation of a certificate.

4 Months9 Months10 Months18 Months48 Months

  • Admission or treatment at a hospital (in-hospital)
  • Dental treatment
  • Upgrading to a higher plan
  • MRI, CT Scans and nuclear medicine
  • Maternity
  • Homes providing constant nursing care
  • Spectacles or contact lenses
  • Internal prosthetic devices
  • Haemodialysis
  • Chemotherapy
  • Orthodontic treatment
  • Ex-gratia drug
  • Periodontics


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