Last updated on: 08/07/2024
Quick Summary
Oneplan Health Insurance offers affordable and flexible health coverage in South Africa, providing access to private healthcare and out-of-hospital benefits. With easy claims processes, a user-friendly app, and options for preloading day-to-day funds onto a claim card, Oneplan aims to make accessing high-quality healthcare simple, accessible, and affordable for individuals.
Oneplan Health Insurance is a leading provider of affordable health coverage in South Africa. They offer comprehensive plans that provide access to private hospitals and other out-of-hospital benefits, ensuring that you receive the care you need when you need it.
With Oneplan, getting healthcare has never been easier or more convenient. Their innovative approach allows members to preload their day-to-day funds onto a Oneplan Claim Card through their user-friendly app. This means that instead of paying for consultations upfront and waiting for reimbursement, members can simply use their card to pay at the time of service.
In addition to easy payment options, Oneplan also boasts a dedicated claims team with nurses available to assist whenever needed. Whether it’s answering questions about your plan or guiding you through the claims process, they are there every step of the way.
It’s important to note that Oneplan Health Insurance is administered by OnePlan Underwriting Managers and underwritten by Bryte Insurance Company Limited – both reputable names in the insurance industry known for providing reliable coverage.
Overall, what sets apart Oneplan from traditional health insurance providers is its commitment towards making high-quality healthcare simple, accessible, and most importantly – affordable!
Benefits of Oneplan Health Insurance
Oneplan Health Insurance offers a range of benefits that make it an attractive option for individuals and families in South Africa. Here are some key advantages of choosing Oneplan:
1. Affordable Coverage:
- With plans starting at just R480 per month, Oneplan provides affordable health insurance options to suit different budgets.
- The pricing is dependent on the individual’s risk profile, ensuring fair premiums based on personal circumstances.
2. Access to Private Healthcare:
- By opting for Oneplan, you gain access to private hospitals and healthcare facilities across South Africa.
- This means you can receive high-quality medical care without having to rely solely on public healthcare services.
3. Out-of-Hospital Benefits:
- In addition to covering hospital expenses, OnePlan also includes out-of-hospital benefits such as doctor consultations, medication costs, pathology tests, radiology scans, and more depending upon your chosen plan.
4. Easy Claims Process:
- OnePlan has simplified the claims process by introducing their innovative Claim Card system through their app which allows members to preload funds onto a card before visiting any provider or specialist.
- This eliminates the need for upfront payments and reimbursement processes.
- Members simply swipe this card after receiving treatment from providers who accept payment via debit cards.
- The claim amount will be deducted directly from available funds loaded onto the member’s Oneplan account, making claiming quick, easy, and hassle-free.
5. Dedicated Claims Team:
- OnePlan understands that navigating through claims can sometimes be challenging.
- Therefore, they have a dedicated team consisting of nurses who are available to assist members with any queries or concerns related to claims.
6. Flexibility and Customization:
- Oneplan offers a range of plan options, including the Core Plan, Core Plus Plan, Blue Plan, Professional Plan, and Executive Plan.
- These plans cater to different needs and budgets, making it easier for individuals and families to find coverage that suits their specific requirements.
7. Convenient App-Based Management:
- Oneplan provides an easy-to-use mobile app where members can manage their health insurance plan on-the-go.
- The app allows you to make claims, renew your policy, request assistance from the dedicated team, and access other services conveniently at your fingertips.
- This digital platform ensures quick response times and efficient management of your healthcare benefits.
In conclusion, Oneplan Health Insurance offers affordable coverage, private healthcare access, out-of-hospital benefits, an easy claims process, dedicated support, flexibility in choosing suitable plans, and convenient app-based management. All these advantages make Oneplan a reliable choice when it comes to securing quality health insurance in South Africa.
Oneplan Health Insurance Plans & Pricing
Oneplan provides several health insurance plans with varying benefits and coverage. Here’s a breakdown of the available plans:
- Core Plan
- Monthly Premium: From R480
- Day-to-Day Benefits:
- Doctor’s Visits: Up to R400 per visit
- Scripted Medication: Up to R170 per script
- Over-the-Counter Medication: Up to R170 per annum
- Pathology/Blood Tests: Up to R485 per event
- Radiology/X-Rays: Up to R485 per event
- Dentistry: Up to R650 per visit
- Maternity Pre-Birth: Up to R650 per visit
- Optometry: Up to R1 130
- In-Hospital Benefits:
- Casualty Illness: Up to R5 600
- Casualty Accident: Up to R5 600
- Accident Cover: Up to R175 000 per insured event
- Repatriation: Up to R15 000 per insured person
- Ambulance & Emergency Services: 24-hour medical assistance with an emergency dedicated line
- Core Plus Plan
- Monthly Premium: From R635
- Day-to-Day Benefits: Similar to the Core Plan
- In-Hospital Benefits: Includes coverage for illness in hospital up to R35 000 per insured event
- Blue Plan
- Monthly Premium: From R955
- Day-to-Day Benefits:
- Doctor’s Visits: Up to R420 per visit
- Scripted Medication: Up to R190 per script
- Over-the-Counter Medication: Up to R190 per annum
- Pathology/Blood Tests: Up to R505 per event
- Radiology/X-Rays: Up to R505 per event
- Dentistry: Up to R685 per visit
- Maternity Pre-Birth: Up to R660 per visit
- Optometry: Up to R1 215
- In-Hospital Benefits:
- Casualty Illness: Up to R5 600
- Casualty Accident: Up to R5 600
- Accident Cover: Up to R230 000 per insured event
- Illness in Hospital: Up to R60 000 per insured event
- Dread Disease: Up to R315 000 per defined disease per year
- Natural Birth & Emergency Caesareans: Up to R55 000 per insured event
- Neonatal: Up to R55 000 per insured event
- Repatriation: Up to R15 000 per insured person
- Ambulance & Emergency Services: 24-hour medical assistance with an emergency dedicated line
- Professional Plan
- Monthly Premium: From R1 330
- Day-to-Day Benefits:
- Doctor’s Visits: Up to R475 per visit
- Scripted Medication: Up to R275 per script
- Over-the-Counter Medication: Up to R275 per annum
- Pathology/Blood Tests: Up to R555 per event
- Radiology/X-Rays: Up to R555 per event
- Dentistry: Up to R810 per visit
- Maternity Pre-Birth: Up to R665 per visit
- Optometry: Up to R1 595
- In-Hospital Benefits:
- Casualty Illness: Up to R5 800
- Casualty Accident: Up to R5 800
- Accident Cover: Up to R260 000 per insured event
- Illness in Hospital: Up to R68 000 per insured event
- Dread Disease: Up to R335 000 per defined disease per year
- Natural Birth & Emergency Caesareans: Up to R65 000 per insured event
- Neonatal: Up to R65 000 per insured event
- Repatriation: Up to R15 000 per insured person
- Ambulance & Emergency Services: 24-hour medical assistance with an emergency dedicated line
- Executive Plan
- Monthly Premium: From R1 765
- Day-to-Day Benefits:
- Doctor’s Visits: Up to R550 per visit
- Scripted Medication: Up to R315 per script
- Over-the-Counter Medication: Up to R315 per annum
- Pathology/Blood Tests: Up to R695 per event
- Radiology/X-Rays: Up to R695 per event
- Dentistry: Up to R905 per visit
- Specialist Cover: Up to R2 215 per visit
- Maternity Pre-Birth: Up to R705 per visit
- Optometry: Up to R1 760
- In-Hospital Benefits:
- Casualty Illness: Up to R6 100
- Casualty Accident: Up to R6 100
- Accident Cover: Up to R340 000 per insured event
- Illness in Hospital: Up to R80 000 per insured event
- Dread Disease: Up to R390 000 per defined disease per year
- Natural Birth & Emergency Caesareans: Up to R75 000 per insured event
- Neonatal: Up to R75 000 per insured event
- Repatriation: Up to R15 000 per insured person
- Ambulance & Emergency Services: 24-hour medical assistance with an emergency dedicated line
Additional Features
- Claims Paid Upfront: Doctor visits can be paid for with a preloaded Oneplan Claim Card.
- Access to Private Hospitals: Coverage includes access to private hospitals and other out-of-hospital benefits.
- Dedicated Claims Team: A team of nurses is available to assist with claims.
- Add-On Products: Options like Excess Buster to waive excesses for a small fee per person.
Important Notes
- Pre-Existing Conditions: Excluded for a maximum of 12 months.
- Waiting Periods, Terms, and Conditions: Apply to all plans and benefits as stipulated in the plan brochures.
- Late Joiner Fees: May be applied.
- Payment Method: All healthcare cover amounts are paid onto the Oneplan Claim Card.
- Underwritten By: Bryte Insurance Company Limited.
How to Get Covered
- Get an Online Quote: Available on the Oneplan website. A form will also be available on this page.
- Sign Up Online: Easy online sign-up process.
- Call Back Option: Customers can request a call back for more information.
How to Make Claims
Making claims with Oneplan Health Insurance is a simple and straightforward process. Here are the steps you need to follow:
1. Keep all your medical receipts
Before making a claim, make sure you have kept all your medical receipts for any consultations, medications, or treatments that you have received.
2. Submitting a claim through the app
One of the convenient features of Oneplan Health Insurance is their user-friendly mobile app. To submit a claim using the app, simply log in to your account and navigate to the “Claims” section.
3. Fill out necessary details
Once in the claims section of the app, fill out all required information such as personal details (name, ID number), policy number, date(s) of treatment or consultation(s), healthcare provider’s name and contact information if applicable.
4. Upload supporting documents
Attach scanned copies or clear photos of each receipt related to your claimed expenses directly from within the application.
5. Submitting Your Claim
After filling out all relevant fields and attaching supporting documentation, submit it electronically by clicking on the ‘Submit’ button at the bottom right corner.
6. Waiting for approval
Once submitted successfully, your claim will be reviewed by Oneplan’s dedicated claims team. They may reach out to you for any additional information or clarification if required. Once your claim is approved, the amount will be deposited into your OneCard account within 24-48 hours. You can then use it to pay for your next medical consultation or treatment without delay.
7. Receiving payment via OneCard
If approved, once deposited into your OneCard account, it can be used immediately to meet the medical expenses. The card functions like a debit card and allows you to pay for medical services directly from this balance.
8. Contact support if needed
In case of any cancellations, rejections, or delay in processing your claim, you can contact Oneplan’s dedicated claims team for assistance. They are available to help you with any queries or concerns related to the claims process.
Remember, it is important to submit your claims as soon as possible after receiving medical treatment or services. This will ensure a smooth and timely reimbursement process.
By following these steps, you can easily make claims with Oneplan Health Insurance and receive the necessary financial support for your healthcare expenses.
Oneplan Health Insurance Reviews on Hellopeter
Oneplan Health Insurance has a significant presence on Hellopeter, with a blend of positive and negative reviews reflecting the varied experiences of its customers. Here’s a summary of the key statistics and feedback (date of capture: 2024/07/08):
Company Profile:
- Verified: Yes
- Overall Rating: 4.56 stars
- Total Reviews: 19,438
- Trustindex Rating: 10
- NPS (Net Promoter Score) All Time: 55 (Recommended: Very Likely)
- Average Time to Reply: 3.88 hours
- Rank in Pet Insurance: #1
Review Breakdown:
- 5 Stars (15,921 reviews): Customers who have left 5-star reviews often highlight exceptional customer service, quick response times, and a smooth claims process. Many of these reviews emphasize the helpfulness of the support staff and their willingness to assist with any issues.
- 4 Stars (1,688 reviews): The 4-star reviews generally reflect positive experiences, although they may include minor issues or suggestions for improvement. These customers appreciate the overall service but may have encountered some delays or minor inconveniences.
- 3 Stars (98 reviews): Reviews with 3 stars typically indicate a mixed experience, where customers found both positive aspects and areas needing improvement. Common themes include satisfactory service with occasional hiccups in communication or processing.
- 2 Stars (300 reviews): The 2-star reviews often point to significant delays in claims processing, difficulty in reaching support, and dissatisfaction with the service provided. These reviews highlight areas where Oneplan could enhance its efficiency and customer support.
- 1 Star (1,431 reviews): Customers who have left 1-star reviews generally express frustration with the claims process, lack of communication, and perceived inadequacy in service. These reviews often cite prolonged wait times and challenges in getting claims approved and reimbursed.
Customer Experiences:
- Positive Feedback: Many customers commend Oneplan for its responsive customer service and the clarity provided in dealing with claims and inquiries. Positive reviews often mention the ease of accessing support and the helpful attitude of the staff.
- Negative Feedback: Conversely, there are several reviews criticizing the delays and difficulties in the claims process. Customers have reported challenges in communication and dissatisfaction with the time taken to resolve their issues.
Overall, while Oneplan Health Insurance has a high rating and many satisfied customers, it also has room for improvement in terms of claims processing and communication. Prospective customers may find it helpful to consider both the positive and negative feedback available on Hellopeter when making their decision.
Frequently Asked Questions
Q1: Is Oneplan Health Insurance available to everyone in South Africa?
A1: Yes, Oneplan Health Insurance is available to all residents of South Africa. They offer health insurance plans for individuals and families.
Q2: How much does Oneplan Health Insurance cost?
A2: The cost of the insurance depends on various factors such as your age, medical history, and the plan you choose. Prices start at R480 per month.
Q3: What benefits are included in a Oneplan Health Insurance plan?
A3:
- Access to private hospitals
- Out-of-hospital benefits including consultations with healthcare providers
- Preloading day-to-day funds onto a Claim Card through their app
Q4: Is there an easy way to make claims with OnePlan?
A4: Yes, OnePlan offers instant claim processing. Members can submit claims easily using their mobile app or online portal.
Q5: Can I manage my policy online?
A5: Yes, members have accessible tools like OneCard which functions like debit cards that allows members to receive payment before seeing any healthcare provider.
Q6: Can I get different coverage options from Oneplan?
A6: Yes, Oneplan has multiple coverage options ranging from core plans, to blue, professional, executive, etc.
Q7: Are they underwritten by a licensed insurer?
A7: Yes, Oneplan is underwritten by Bryte Insurance Company Ltd, a licensed insurer.
