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Stratum Benefits Elite (🇿🇦 2025*)

💙 Overall, Stratum Benefits Elite is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Stratum Benefits Elite Plan starts from R481 ZAR. Stratum Benefits has a trust score of 4.5.

🔎 Provider	🥇 Stratum Benefits Elite
🟥 Years in Operation	24 years
🟧 Underwriters	Guardrisk Insurance Company Limited (FSP 75)
🟨 Market Share in South Africa	>5%
🟩 Gap Cover Waiting Period	3 Months
🟦 Do Exclusions Apply	✅ Yes
🟪 Average Monthly Premium	R481
🟥 Oncology Benefit	✅ Yes
🟧 In-Hospital Benefit	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes

Stratum Benefits Elite – 7 Key Point Quick Overview

Stratum Benefits Elite Overview

💙 The Stratum Benefits Elite is one of eleven plans that starts from R481 per month. Stratum Benefits’ Base has benefits for maternity, sub-limits, radiology, cancer, MRI and other scans, physical rehabilitation, outpatient specialist consults, casualties, and more.

👉🏿 Stratum Benefits Gap Cover has 5 plans to choose from:

✅️ Stratum Benefits Elite 500

✅️ Stratum Benefits Compact 300

✅️ Stratum Benefits Access Optimiser

✅️ Stratum Benefits Access Co pay Plus 300

✅️Stratum Benefits Meridian 400

🟥 Membership Type	🟥 Monthly Contribution
🟧 Individuals <64 years	🟧 R481
🟨 If the entire family is <64 years	🟨 R591
🟩 If you are 65 years or older	🟩 R780
🟦 If you or a dependent is >65 years	🟦 R954

Stratum Benefits Elite Benefits and Cover Breakdown

🟥 Gap Benefit	Covers in and out-of-hospital expenses up to 500% with an annual limit of R210 580 per insured person.
🟧 Co-Payment Benefit	Includes cover for admission and procedure co-payments, penalty co-payments (up to R15,000 per year), and robotic surgery co-payments (up to R10,000 per year).
🟨 Dental Cover	Dental procedures, such as dental implants and wisdom teeth extractions: Limited to R 50 000 per policy per year. Also covers co-payments for admissions and procedures up to R210 580 per insured person per year.
🟩 Maternity Cover	Includes cover for pre-natal consultations, childbirth shortfalls, post-natal consultation shortfalls, preventative procedures, childhood immunizations, birth control, and private room shortfalls.
🟦 Sub-Limit Benefit	Covers specific medical procedures such as colonoscopies, enterostomies, gastroscopies (up to R6,500 per event), internal prosthetic devices (up to R40,000 per event), and renal dialysis treatments (up to R30,000 per event). internal prosthetic device up to R 10 000 per insured person per event.
🟪 Radiology Cover	Covers sub-limit benefits for MRI, CT, and PET scans (up to R5,000 per event) and a top-up benefit for the same scans (up to R5,000 per year).
🟥 Cancer Benefit	Covers breast reconstruction (up to R30,000 per lifetime), cancer treatment shortfalls (up to R210 580), and cancer treatment top-ups (up to R210 580 per year).
🟧 Physical Rehab	Provides cover up to R10,000 per insured person per year.
🟨 Out-Patient Specialist Consultation Benefit	Covers up to R1,300 per consultation, limited to 3 consultations per policy per year.
🟩 Casualty Benefit – Accidents and Illness	Reimburses shortfalls or total costs for casualty events up to R15,000 per policy per year.
🟦 Trauma Counselling	Provides cover up to R10,000 per policy per year.
🟪 Preventative Care	Covers various tests and immunizations up to R1,800 per policy per year.
🟥 Private Room Benefits	Covers up to R3,500 per policy per year.
🟧 Accidental Death and Disability	Provides cover for the policyholder, spouse (up to R25,000 per insured person), and dependents (up to R5,000 per insured person) with a limit of 1 event per insured person per year.
🟨 First-Time Cancer Diagnosis	Covers up to R30,000 per insured person in their lifetime.
🟩 Medical Aid Contribution Waiver	Covers up to R4,500 per month for six months.
🟦 Stratum Benefits Premium Waiver	Pays the premiums if the policyholder or the premium payer dies or becomes totally and permanently disabled. Employer-paid premiums must be included in the total salary package.
🟪 Lifestyle Benefits	Offers access to e-learning options through Boston Online Home Education for high school students in grades 8 to 12.
🟥 International Travel Insurance	Covers the entire family for acute illness and injury during pleasure trips outside South African borders, with a maximum of 31 days per trip and one per policy per year.

Stratum Benefits Elite Exclusions and Waiting Periods

Elite Exclusions

💙 Suppose you claim within the first 10 months of cover for certain medical events/procedures (such as adenoidectomy, cardiovascular procedures, cataract removal, dentistry, etc.). In that case, Stratum Benefits will only cover 20% of the claim amount.

Elite Waiting Periods

💙 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.

💙 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.

Stratum Benefits Elite vs Other Gap Cover Plans

🔎 Provider	🥇 Stratum Benefits Elite	🥈 Cura Administrators Gap Advanced Plus	🥉 Sirago Gap Assist
🟥 Years in Operation	24 years	26 years	30 years
🟧 Underwriters	Guardrisk Insurance Company Limited (FSP 75)	GENRIC Insurance Company Limited	GENRIC Insurance Company Limited (FSP: 43638)
🟨 Market Share in South Africa	>5%	<5%	>10%
🟩 Gap Cover Waiting Period	3 Months	3 – 12 months	From 3 months (up to 12)
🟦 Do Exclusions Apply	✅ Yes	✅ Yes	✅ Yes
🟪 Average Monthly Premium	R481	R480	R401
🟥 Oncology Benefit	✅ Yes	✅ Yes	✅ Yes
🟧 In-Hospital Benefit	✅ Yes	✅ Yes	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes	✅ Yes	✅ Yes
🟩 Maternity Benefit	✅ Yes	✅ Yes	✅ Yes
🟦 Scopes and Scans	✅ Yes	✅ Yes	None
🟪 Co-payment Cover	✅ Yes	✅ Yes	✅ Yes
🟥 Emergency Room	✅ Yes	✅ Yes	✅ Yes
🟧 Accidental Cover	✅ Yes	✅ Yes	✅ Yes
🟨 Trauma Counseling	✅ Yes	✅ Yes	None
🟩 Premium Waiver	None	✅ Yes	✅ Yes
🟦 Non-DSP Co-Payment	None	✅ Yes	✅ Yes
🟪 Prostheses	✅ Yes	✅ Yes	✅ Yes
🟥 Travel Cover Extender	✅ Yes	✅ Yes	None
🟧 Accidental Death/ Permanent Disability	✅ Yes	✅ Yes	None

Our Verdict on Stratum Benefits Elite

💙 In conclusion, Stratum Benefits Elite is a popular and well-established gap cover plan offered by Stratum Benefits in South Africa. Its comprehensive range of benefits and competitive premiums provides valuable cover for various medical expenses.

💙 The plan covers many services, including in and out-of-hospital expenses, co-payments, dental care, maternity benefits, radiology, cancer treatment, rehabilitation, specialist consultations, and more.

💙 Additionally, we found that Stratum Benefits Elite offers 24/7 medical emergency assistance and has a high trust rating.

Stratum Benefits Elite Frequently Asked Questions

What does Stratum Benefits Elite cover?

Stratum Benefits Elite covers a wide range of medical expenses, including in and out-of-hospital treatments, co-payments, dental care, maternity benefits, radiology, cancer treatment, rehabilitation, and specialist consultations.

How much are the premiums for Stratum Benefits Elite?

The premiums for Stratum Benefits Elite start from R481 per month for individuals under 64 years of age. However, the exact premium may vary based on factors such as age and family composition.

Does Stratum Benefits Elite cover pre-existing conditions?

Stratum Benefits Elite has a 12-month waiting period for pre-existing conditions. This means that treatments, procedures, surgeries, and investigations related to illnesses or medical conditions diagnosed within the first 12 months of starting the policy are not covered.

What are the waiting periods for Stratum Benefits Elite?

Stratum Benefits Elite has a general waiting period of three months for all claims except accidental events. Additionally, there is a 12-month waiting period for pre-existing conditions.

Can I upgrade my plan from Stratum Benefits Base to Stratum Benefits Elite?

Yes, upgrading your plan from Stratum Benefits Base to Stratum Benefits Elite is possible. You can contact Stratum Benefits directly to inquire about the upgrade process and any associated changes to premiums or benefits.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.