Advertisement Advertisement

Stratum Benefits

Access Co pay Plus 300

About this plan

Focuses on hospital admission and procedure co-payments while also providing 300% specialist tariff shortfall cover for qualifying claims.
Monthly premium
From
R444
per month

What's covered

Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health

Waiting periods

General
3 months
Pre-existing conditions
12 months

Access Co pay Plus 300

Stratum Benefits Access Co Pay Plus 300

Stratum Benefits Access Co pay Plus 300 (πŸ‡ΏπŸ‡¦ 2025*)

πŸ’™ Overall, Stratum Benefits Access Co pay Plus 300 is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Plan starts from R404 ZAR. Stratum Benefits has a trust score of 4.5.  
πŸ”Ž ProviderπŸ₯‡ Stratum Benefits Access Co pay Plus 300
πŸŸ₯ Years in Operation25 years
🟧 UnderwritersGuardrisk Insurance Company Limited (FSP 75)
🟨 Market Share in South Africa>5%
🟩 Gap Cover Waiting Period3 Months
🟦 Do Exclusions Applyβœ… Yes
πŸŸͺ Average Monthly PremiumR404
πŸŸ₯ Oncology Benefitβœ… Yes
🟧 In-Hospital Benefitβœ… Yes
🟨 Out-of-Hospital Coverβœ… Yes
  access-co-pay-plus300

Stratum Benefits Access Co pay Plus 300 - 7 Key Point Quick Overview

  1. βœ… Stratum Benefits Access Co pay Plus 300 Overview
  2. βœ… Stratum Benefits Access Co pay Plus 300 Premiums
  3. βœ… Stratum Benefits Access Co pay Plus 300 Benefits and Cover Breakdown
  4. βœ… Stratum Benefits Access Co pay Plus 300 Exclusions and Waiting Periods
  5. βœ… Stratum Benefits Access Co pay Plus 300 vs Other Gap Cover Plans
  6. βœ… Our Verdict on Stratum Benefits Access Co pay Plus 300
  7. βœ… Stratum Benefits Access Co pay Plus 300 Frequently Asked Questions

Stratum Benefits Access Co pay Plus 300 Overview

πŸ’™ The Stratum Benefits Access Co pay Plus 300 is one of eleven plans that starts from R404 per month. Stratum Benefits’ Base has benefits for first-time cancer diagnosis, accidental death, casualty, illness, radiology, maternity cover, and more.   πŸ‘‰πŸΏ Stratum Benefits Gap Cover has 5 plans to choose from:   βœ…οΈ Stratum Benefits Elite 500 βœ…οΈ Stratum Benefits Compact 300 βœ…οΈ Stratum Benefits Access Optimiser βœ…οΈ Stratum Benefits Access Co pay Plus 300 βœ…οΈStratum Benefits Meridian 400Access Co-Pay Plus 300

Stratum Benefits Access Co pay Plus 300 Premiums

πŸŸ₯ Membership Type🟩 Monthly Contribution
🟧 Individuals or Families <64 years🟦 R404
🟨 Individuals or Families>65 yearsπŸŸͺ R537
  Access co-Pay Plus 300 Contributions

Stratum Benefits Access Co pay Plus 300 Benefits and Cover Breakdown

πŸ’™ This plan is an enhanced alternative designed to encompass specific medical procedures not included in the policyholder’s existing medical cover.   πŸ’™ It applies to individuals aged 65 and above and families with at least one member aged 65 or above, who will be subjected to the premium associated with a family or individuals over 65.   πŸ’™ Under this plan, the benefits offered are contingent upon an annual Out-of-Pocket Limit (OPL) of R210 580 per policy, regardless of whether the policyholder is covered as an individual or as part of a family. Consequently, any approved claim amounts will be deducted from the OPL.  

Access Co pay Plus 300 Access Cover

πŸ’™ This provides cover for procedures that are not typically covered by medical aid.
πŸŸ₯ The procedure not covered by Medical AidAccess Cover Amount Provided
Adenoidectomy, myringotomy (grommets) or tonsillectomyR15 000
🟧 Arthroscopic SurgeryR72,000
🟨 Back / Neck SurgeryR72,000
🟩 Bunion SurgeryR20,000
🟦 The cochlear implant, auditory brain implant, and internal nerve stimulator surgery (Including the procedure, device, processor, and hearing aids)R85,000
πŸŸͺ Dental Procedures for impacted teeth (children <18 years)R20,000
πŸŸ₯ Dental procedures – reconstructive surgery because of an accidentR85,000
🟧 Endoscopic ProceduresR10,000
🟨 Functional Nasal SurgeryR30,000
🟩 Joint replacement surgery (Including non-PMB joint replacements and internal prosthetic devices)R60,000
🟦 Knee or shoulder surgeryR30,000
πŸŸͺ MRI or CT scan is required due to an accidental eventR15,000
πŸŸ₯ Non-cancerous breast conditions (including breast reconstruction of a breast not affected by cancer)R25,000
🟧 Esophageal reflux and hiatus hernia surgeryR60,000
🟨 Removal of varicose veinsR25,000
🟩 Skin disorders (including benign growths or lipomas)R25,000
 

Access Co pay Plus 300 Benefits

πŸŸ₯ Gap BenefitGap Benefit covers in and out-of-hospital expenses up to 300% with an annual Out-of-Pocket Limit (OPL) of R210 580 per insured person.
🟧 Co-payment BenefitAllows unlimited claims for co-payments and deductibles, as long as they don’t exceed R6,500 per policy per year.
🟨 Dental Coverβ€’ Dental procedures, such as dental implants and wisdom teeth extractions: Limited to R 30 000 per policy per year. Dental procedures due to accidental events or cancer treatment: Subject to the OPL of R 210 580 per insured person per year
🟩 Maternity CoverIncludes cover for shortfalls in childbirth expenses both in and out-of-hospital, subject to medical aid payments and specific benefit conditions. Stratum Benefits refunds co-payments and deductibles for elective caesareans.
🟦 Radiology CoverProvides Gap Cover up to 300% of shortfalls, with unlimited cover for co-payments and deductibles from medical aid savings or out-of-pocket expenses.
πŸŸͺ Casualty Benefit – Accidents and IllnessCovers accidental events and illness out-of-hospital, reimbursing shortfalls or total costs if paid from medical aid savings or out-of-pocket expenses. Limited to R3,000 per policy per year.
πŸŸ₯ Accidental Death and DisabilityCover offers R5,000 each for the insured person and their spouse in the event of total and permanent disability or death due to an accident, limited to one event per year.
  Access Co-Pay Plus 300 GAP Benefits

Stratum Benefits Access Co pay Plus 300 Exclusions and Waiting Periods

Access Co pay Plus 300 Exclusions

πŸ’™ Suppose you claim within the first 10 months of cover for certain medical events/procedures (arthroscopic surgery, bunion surgery, reconstructive dental procedures, etc.). In that case, Stratum Benefits will only cover 20% of the claim amount.  

Access Co pay Plus 300 Waiting Periods

πŸ’™ Waiting periods apply from the policy start date, policy option upgrades, and for new members added after the initial policy start date. There is a three-month general waiting period for all claims except accidental events.   πŸ’™ Additionally, there is a 12-month waiting period for pre-existing conditions, including investigations, procedures, surgeries, and treatments related to illnesses or medical conditions diagnosed within 12 months of starting the policy with Stratum Benefits.   Access Co-Pay Plus 300 Gap Benefits 2

Stratum Benefits Access Co pay Plus 300 vs Other Gap Cover Plans

 
πŸ”Ž ProviderπŸ₯‡ Stratum Benefits Access Co pay Plus 300πŸ₯ˆ Sirago Gap LiteπŸ₯‰ Standard Bank GapAssist Essential
πŸŸ₯ Years in Operation25 years31 years62 years (Standard Bank)
🟧 UnderwritersGuardrisk Insurance Company Limited (FSP 75)GENRIC Insurance Company Limited (FSP: 43638)Standard Insurance Limited
🟨 Market Share in South Africa>5%>10%<10%
🟩 Gap Cover Waiting Period3 MonthsFrom 3 months (up to 12)12 Months
🟦 Do Exclusions Applyβœ… Yesβœ… Yesβœ… Yes
πŸŸͺ Average Monthly PremiumR404R289R397
πŸŸ₯ Oncology Benefitβœ… YesNoneNone
🟧 In-Hospital Benefitβœ… Yesβœ… Yesβœ… Yes
🟨 Out-of-Hospital Coverβœ… Yesβœ… Yesβœ… Yes
🟩 Maternity Benefitβœ… Yesβœ… YesNone
🟦 Scopes and Scansβœ… YesNoneβœ… Yes
πŸŸͺ Co-payment Coverβœ… Yesβœ… YesNone
πŸŸ₯ Emergency Roomβœ… Yesβœ… Yesβœ… Yes
🟧 Accidental Coverβœ… Yesβœ… Yesβœ… Yes
🟨 Trauma CounselingNoneNoneβœ… Yes
🟩 Premium WaiverNoneNoneβœ… Yes
🟦 Non-DSP Co-paymentNoneβœ… YesNone
πŸŸͺ Prosthesesβœ… YesNoneNone
πŸŸ₯ Travel Cover ExtenderNoneNoneNone
🟧 Accidental Death/ Permanent Disabilityβœ… YesNoneβœ… Yes
 

πŸ‘‰πŸΏ Discover more about Preventative Care?

Access Co-Pay Plus 300 Waiting period

Our Verdict on Stratum Benefits Access Co pay Plus 300

πŸ’™ In our experience, Stratum Benefits Access Co-pay Plus 300 is a comprehensive gap cover plan offered by Stratum Benefits in South Africa. Co-pay Plus 300 covers medical expenses not covered by existing medical aid plans. The plan also offers benefits such as Gap Benefits, Co-payment Benefits, Dental Coverage, Maternity Coverage, Radiology Coverage, and more.   πŸ’™ However, according to our research, there is a three-month period for general claims and a 12-month waiting period for pre-existing conditions.  

Stratum Benefits Access Co pay Plus 300 Frequently Asked Questions

Can I apply for Stratum Benefits Access Co pay Plus 300 if I am under 65?

No, Stratum Benefits Access Co pay Plus 300 is specifically designed for individuals aged 65 and above and families with at least one member aged 65 or above.  

Does Access Co pay Plus 300 provide cover for pre-existing conditions?

Yes, the plan covers pre-existing conditions after a 12-month waiting period.  

What is the maximum limit for co-payments and deductibles under the Access Co-pay Plus 300 Co-payment Benefit?

The maximum limit for co-payments and deductibles under the Co-payment Benefit is R6,500 per policy per year.  

Are there waiting periods for specific procedures or treatments on Access Co pay Plus 300?

Yes, there is a three-month waiting period for general claims, excluding accidental events, and a 12-month waiting period for pre-existing conditions.  

Can I use the Access Cover for medical procedures already covered by my existing medical aid?

No, the Access Cover is specifically designed to provide cover for procedures not typically covered by your existing medical aid, filling the gaps in your cover.
Get a FREE Gap Cover Quote

You Might Also Like

7 Actionable Ways to save 32% on your MEDICAL AID in 14 days.