SA's No 1 Insurance Blog

Two quick questions for you today:

  1. Are you on a bottom of the range medical aid?
  2. Are you willing to spend R300 to give it a boost?

If you answered “yes” to both questions then we have some good news.

We’ve written about Oneplan before. What we did was look at all the plans, and specifically the health benefits (not the hospital benefits), which were then compared to Discovery Health.
It’s still a great article but a few things have changed since then, one of which is the cost which changed on the 1st of March 2017. This time around let’s look at them plan by plan starting off with their cheapest option – the Oneplan Health

So what would it cost you to join the Oneplan Health plan (core option)?

Cost is always the awkward bit, so let’s get it out of the way right at the beginning:

Single R310
Single with 1 child R515
Single with 2 children R715
Single with 3 children R895
Single with 4 children R1135
A couple R600
A couple with 1 child R800
A couple with 2 children R995
A couple with 3 children R1180
A couple with 4 children R1410

So what do I get for this?

Let us split it up between the day-to-day stuff like doctor and dentist visits, and the serious stuff like hospital visits.

So here’s the bad news about hospital visits:
The Oneplan Health plan does not cover the hospital side of the equation, but

  • Yes, it will cover accidental HIV infection treatment.
  • Yes, it will cover trauma counselling
  • Yes, it will provide 24 hour medical assistance via a dedicated telephone line
  • Yes, it will provide transport in an ambulance to the nearest hospital in the event of a life threatening medical emergency

Don’t stress,  if it’s hospital cover you’re most concerned about, Oneplan has other plans which will take care of this.

So let’s look at the good news, shall we?

  • Doctor visits – Up to R260 is paid per visit (Specialist visits are not covered though)
  • Prescription medicine – Up to R170 per prescription is paid
  • Blood tests – Up to R400 per event paid
  • X-rays – Up to R400 per event paid
  • Dentistry – Up to R455 per visit paid
  • Maternity pre-birth – Up to R490 per visit paid
  • Optometry – Up to R800 paid

Can I see the doctor as often as I like?

Now let us not give you the impression that unlimited visits are covered. The actual benefits are capped as follows:

  • Single persons – R9, 310 per year
  • 2 to 3 persons – R14, 470 per year
  • 4 or more persons – R17, 920 per year

Obviously this makes a lot of sense for the single person – they could see the doctor and dentist every month and have it paid for by Oneplan!
Something else I must point out here is that these benefits are ‘use it or lose it’. With a medical aid savings account, what you don’t use gets carried over to the next year, and the next, and the next.

Let’s quickly compare the day-to-day benefits to an actual medical aid day-to-day savings benefit shall we?

Oneplan Health Discovery Health Classic Saver
Singles R9, 310 R7, 728
3 persons R14, 470 R16, 896
4 persons R17, 920 R19, 980

Okay, first off we can see is that the Discovery Health Classic Saver offers more in terms of day-to-day expenses for a family. But bear in mind the cost of doing so:

Oneplan Health Discovery Health Classic Saver
Singles R300 monthly R644 monthly
A couple and 1 child (3 persons) R835 monthly R1, 408 monthly
A couple and 2 children (4 persons) R1, 075 monthly R1, 665 monthly

Can I claim straight away?

Another thing to consider is that there are waiting periods before being allowed to claim. The standard waiting period is 30 days except when it comes to:

  • Maternity pre-birth which has a 7 month waiting period for brand new policies and 4 months from date of conception for existing policies,
  • Optometry which has a 12 month waiting period
  • Pre-existing conditions are also excluded for a minimum of 12 months. I understand this to mean that waiting periods could be longer, so you’d need to ask when applying.

So what do we think about the Oneplan Health plan?

Please understand what we’re saying in this article:

  • Oneplan Health plan is not the same as a medical aid. If you can afford medical aid, then please join one, and Discovery Health, since I’ve been using them for comparison purposes, happens to be an excellent choice.
  • The Oneplan Health plan does not cover hospital expenses. It’s purely there for the day-to-day medical expenses. And remember what I said earlier – use it or lose it since the benefits don’t carry over from year to year.

So when does the Oneplan Health Plan make sense?

We think it makes perfect sense when combined with a cheaper medical aid hospital plan.

For argument’s sake, let’s say you’re a single person who doesn’t know what the inside of a hospital looks like. Let’s assume this person is on the Discovery Health KeyCare Core plan with hospital benefits only:

KeyCare Core KeyCare Core + Oneplan Health KeyCare Plus includes doctor visits
R1, 408 monthly R1, 708 monthly R1, 906 monthly

Come to think of it…

Remember what we said earlier about your medical savings benefit carrying over from year to year?

With the Oneplan Health Plan you could save that money every year by claiming instead from Oneplan. You get to grow your MSA (Medical Savings Account) on your medical aid for the day when you really need it. Think long term. Think that maybe your child will one day need braces.

Do yourself a favour, find out how much braces cost. A year ago I enquired and was told to bargain on R50, 000 for the full treatment. Who knows what it is now?

Hopefully we’ve made our point.

InsuranceFundi has partnered with some of SA’s most reputable insurance and investment companies. We believe that everyone should have access to a wide range of comprehensive and affordable solutions. Pick the product you are interested in below, and expect a call-back from our partners.

Until next time.

The InsuranceFundi Team