The Best Medical Aids
The Best Hospital Plans
Try our new AI Assistant
...
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 R404 ZAR. Stratum Benefits has a trust score of 4.5.
π Provider | π₯ Stratum Benefits Elite |
π₯ Years in Operation | 24 years |
π§ Underwriters | Guardrisk Insurance Company Limited (FSP 75) |
π¨ Market Share in South Africa | >5% |
π© Gap Cover Waiting Period | 3 Months |
π¦ Do Exclusions Apply | β Yes |
πͺ Average Monthly Premium | R404 |
π₯ Oncology Benefit | β Yes |
π§ In-Hospital Benefit | β Yes |
π¨ Out-of-Hospital Cover | β Yes |
The Stratum Benefits Elite is one of eleven plans that starts from R404 per month. Stratum Benefitsβ 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 eleven plans to choose from:
π₯ Membership Type | π₯ Monthly Contribution |
π§ Individuals <64 years | π§ R404 |
π¨ If the entire family is <64 years | π¨ R496 |
π© If you are 65 years or older | π© R656 |
π¦ If you or a dependent is >65 years | π¦ R801 |
π₯ Gap Benefit | Covers in and out-of-hospital expenses up to 500% with an annual limit of R185,873 per insured person. |
π§ Co-Payment Benefit | Includes cover for admission and procedure co-payments, penalty co-payments (up to R13,000 per year), and robotic surgery co-payments (up to R10,000 per year). |
π¨ Dental Cover | Provides gap benefit cover up to 500% with varying limits (R8,000 to R24,000 per year) depending on the procedure. Also covers co-payments for admissions and procedures up to R185,837 per insured person per year. |
π© Maternity Cover | Includes cover for pre-natal consultations, childbirth shortfalls, post-natal consultation shortfalls, preventative procedures, childhood immunizations, birth control, and private room shortfalls. |
π¦ Sub-Limit Benefit | Covers specific medical procedures such as colonoscopies, enterostomies, gastroscopies (up to R5,000 per event), internal prosthetic devices (up to R30,000 per event), and renal dialysis treatments (up to R30,000 per event). |
πͺ Radiology Cover | Provides gap benefit cover up to R185,837 per insured person per year, along with co-payment cover for admissions and procedures. Also 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). |
π₯ Cancer Benefit | Covers breast reconstruction (up to R30,000 per lifetime), cancer treatment shortfalls (up to R185,837), and cancer treatment top-ups (up to R185,837 per year). |
π§ Physical Rehab | Provides cover up to R10,000 per insured person per year. |
π¨ Out-Patient Specialist Consultation Benefit | Covers up to R1,300 per consultation, limited to 3 consultations per policy per year. |
π© Casualty Benefit β Accidents and Illness | Reimburses shortfalls or total costs for casualty events up to R12,000 per policy per year. |
π¦ Trauma Counselling | Provides cover up to R10,000 per policy per year. |
πͺ Preventative Care | Covers various tests and immunizations up to R1,300 per policy per year. |
π₯ Private Room Benefits | Covers up to R3,000 per policy per year. |
π§ 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. |
π¨ First-Time Cancer Diagnosis | Covers up to R30,000 per insured person in their lifetime. |
π© Medical Aid Contribution Waiver | Covers up to R4,500 per month for six months. |
π¦ 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. |
πͺ Lifestyle Benefits | Offers access to e-learning options through Boston Online Home Education for high school students in grades 8 to 12. |
π₯ 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. |
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.
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.
π Provider | π₯ Stratum Benefits Elite | π₯ Cura Administrators Gap Advanced Plus | π₯ Sirago Gap Assist |
π₯ Years in Operation | 24 years | 26 years | 30 years |
π§ Underwriters | Guardrisk Insurance Company Limited (FSP 75) | GENRIC Insurance Company Limited | GENRIC Insurance Company Limited (FSP: 43638) |
π¨ Market Share in South Africa | >5% | <5% | >10% |
π© Gap Cover Waiting Period | 3 Months | 3 β 12 months | From 3 months (up to 12) |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R404 | R437 | R342 |
π₯ Oncology Benefit | β Yes | β Yes | β Yes |
π§ In-Hospital Benefit | β Yes | β Yes | β Yes |
π¨ Out-of-Hospital Cover | β Yes | β Yes | β Yes |
π© Maternity Benefit | β Yes | β Yes | β Yes |
π¦ Scopes and Scans | β Yes | β Yes | None |
πͺ Co-payment Cover | β Yes | β Yes | β Yes |
π₯ Emergency Room | β Yes | β Yes | β Yes |
π§ Accidental Cover | β Yes | β Yes | β Yes |
π¨ Trauma Counseling | β Yes | β Yes | None |
π© Premium Waiver | None | β Yes | β Yes |
π¦ Non-DSP Co-Payment | None | β Yes | β Yes |
πͺ Prostheses | β Yes | β Yes | β Yes |
π₯ Travel Cover Extender | β Yes | β Yes | None |
π§ Accidental Death/ Permanent Disability | β Yes | β Yes | None |
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 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.
The premiums for Stratum Benefits Elite start from R404 per month for individuals under 64 years of age. However, the exact premium may vary based on factors such as age and family composition.
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.
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.
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 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.
You might also like
Free Gap Cover Quote
We work with leading medical aid companies in South Africa.
π Report a bug or outdated data to be updated to [email protected]
Β© Medicalaid.com | All rights Reserved |
Copyright 2024
Top 5 Medical Aids
Top 5 Gap Cover Plans
In the Media
Your compare list
BackAFFORDABLE HEALTH PLANS FROM R469 PER MONTH