Bloom Health4Me Gold Plan
Overall, the Bloom Health4Me Gold Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and chronic medication to up to 3 Family Members. The Bloom Health4Me Gold Plan starts from R598 ZAR. Health4Me has a trust rating of 10.
| 🔎 Medical Health Plan | 🥇 Bloom Health4Me Bronze |
| 🌎 International Cover | None |
| 👤 Main Member Contribution | R598 – R933 |
| 👥 Adult Dependent Contribution | R598 – R933 |
| 👶 Child Dependent Contribution | R348 – R512 |
| 🔁 Gap Cover | None |
| 📈 Screening and Prevention | ✅ Yes |
| 💙 Medical Savings Account | None |
| 🍼 Maternity Benefits | ✅ Yes |
| ➡️ Pre and Postnatal Care | ✅ Yes |
Bloom Health4Me Gold Plan – 7 Key Point Quick Overview
- ✅ Bloom Health4Me Gold Plan Overview
- ✅ Bloom Health4Me Gold Plan Premiums
- ✅ Bloom Health4Me Gold Plan Benefits and Cover Comprehensive Breakdown
- ✅ Bloom Health4Me Gold Plan Exclusions and Waiting Periods
- ✅ Bloom Health4Me Gold Plan vs Other Providers or Medical Aid Schemes
- ✅ Our Verdict on the Bloom Health4Me Gold Plan
- ✅ Bloom Health4Me Gold Plan Frequently Asked Questions
Bloom Health4Me Gold Plan Overview
The Bloom Health4Me Gold Plan is one of 3, starting from R598. The Bloom Health4Me Gold Option is an excellent health insurance plan for those looking for comprehensive coverage. The plan covers a range of medical expenses, including chronic medication, specialist visits, additional maternity benefits, and HIV/AIDS benefits.
Gap Cover is unavailable on the Bloom Health4Me Gold Plan. However, Bloom offers 24/7 medical emergency assistance. According to the Trust Index, Bloom Health4Me has a trust rating of 10.
Bloom Health Insurance has the following options:
Bloom Health4Me Gold Plan Premiums
| 🔎 Benefit Group | 🔴 Major Medical Event Benefit | 🟡 Principal Member | 🟢 Spouse (per Spouse) | 🔵 Child (per child) |
| 🔴 Day-to-Day | None | R598 | R598 | R348 |
🟡 Day-to-Day plus the following:
Accident and Emergency
Hospital Cash and Maternity Lump Sum
Funeral Benefit | Base | R845 | R845 | R468 |
🟢 Day-to-Day plus the following:
Accident and Emergency
Hospital Cash and Maternity Lump Sum
Funeral Benefit | Standard | R933 | R933 | R512 |
Bloom Health4Me Gold Plan Benefits and Cover Comprehensive Breakdown
Acquiring healthcare is a crucial aspect of a person’s overall health and well-being. Nevertheless, private healthcare options, such as medical schemes, remain financially inaccessible to a significant portion of South Africa. Momentum Health4Me aims to provide an affordable healthcare coverage solution for individuals with a monthly income of less than R30,000 through Bloom.
Momentum Health4Me, aligning with Momentum’s commitment to innovation and adaptability, employs a modular approach. This enables you to select a blend of benefits that best aligns with your requirements and financial capacity.
Momentum Health4Me delivers exceptional value by leveraging vast expertise and proficiency in the industry and a robust network of provider partnerships. This allows Bloom to offer many South Africans an economical healthcare insurance solution.
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Health4Me Gold Day-to-Day Benefits
| 🟥 GP Benefit | Unlimited visits per member per year to a Network GP |
| 🟧 Procedures in the GP Room | Minor medical procedures, such as suturing and nebulization, are performed in-room as part of a Network GP consultation. |
| 🟨 Hello Doctor | Hello Doctor GP consultations are unlimited.
Hello Doctor consultations are available via chat, telephone, or video call.
During Hello Doctor consultations, formulary-based medications are prescribed per Network acute medication formulary rules and protocols.
Hello Doctor consultations include pathology referrals per the Health4Me pathology list.
Hello Doctor consultations include radiology referrals according to the Health4Me radiology list. |
| 🟩 Specialist Benefit | Limited to two visits, each limited to R1,220, and a maximum of R2,440 per member/family per year are permitted.
Members can consult any specialist, pending referral by a Network GP and pre-approval.
According to the applicable Health4Me pathology and radiology lists, the specialist can refer the member for pathology and radiology.
The member will bear any deficits. |
| 🟦 Acute Medicine | Formulary of acute medications prescribed by the Network
Standards and procedures are followed. |
| 🟪 Chronic Medication | The following chronic conditions are covered:
Addison’s Disease
Asthma
Bipolar Mood Disorder
Bronchiectasis
Cardiac Dysrhythmias
Cardiac Failure
Cardiomyopathy
Chronic Obstructive Pulmonary Disease
Chronic Renal Disease
Coronary Artery Disease
Crohn’s Disease
Glaucoma, etc.
Medication for chronic conditions is administered per the Network’s chronic medication formulary.
Health4Me provides pathology and radiology for condition monitoring per the applicable pathology and radiology lists.
Pre-approval is required. |
| 🟥 HIV Benefit | Post-exposure prophylaxis (PEP) medication is administered per the HIV medication formulary of the Network to prevent HIV infection in the event of accidental exposure to blood or fluids from an infected person or by any other means.
Antiretroviral medication is provided per the HIV medication formulary prescribed by the Network.
Health4Me provides pathology related to condition monitoring per the applicable pathology list.
Pre-approval is required. |
| 🟧 Maternity Benefit | Limited to 1 Embryonic growth 2D scan per member per pregnancy
Antenatal pathology tests linked to a Network GP visit and referred by a Network GP are performed per the Network prescribed acute medication formulary, rules, and protocols.
Pre-approval is required.
1 additional fetal development 2D scan per member per pregnancy
Antenatal support (access to credible, up-to-date information on all parenting-related topics) via BabyYumYum Postpartum assistance at home from a nurse or midwife with bathing, swaddling, latching, and feeding.
The nurse or midwife makes home visits on day 2 and week 2 after the birth. |
| 🟨 Basic Pathology | Unlimited pathology cover when linked to a Hello Doctor or Network GP visit and referred by a Hello Doctor or Network GP, per the Health4Me pathology list. |
| 🟩 Basic Radiology | Unrestricted cover for black-and-white x-rays when linked to a Hello Doctor or Network GP visit and referred by a Hello Doctor or Network GP, per the applicable Health4Me radiology list. |
| 🟦 Basic and Emergency Dentistry | Any dentist on the Dental Network is covered.
Basic dental care includes fillings, extractions, infection control, teeth cleaning, and polishing.
Specialized dental procedures such as bridges, crowns, surgical extractions, implants, root canals, gold fillings, dentures, and braces are not covered.
Provided per the protocols of the Dental Network and the Health4Me dentistry list. |
| 🟪 Basic Optometry | Covered at any Optical Network optometrist Benefit available every two years
Limited to 1 Eye exam and 1 pair of clear single-vision or bi-focal lenses with a standard frame.
Sunglasses, tinted lenses, hard coating, and contact lenses are not covered.
Compliant with Optical Network protocols and the Health4Me-approved optometry list. |
| 🟥 Flu Vaccination | Limited to 1 Flu vaccination per member per year, preferably at a Dis-Chem, Clicks, MediRite, or Pick n Pay pharmacy clinic. |
| 🟧 COVID-19 Screening | Limited to 1 COVID-19 screening test per member per year is covered, pending a Hello Doctor, Network GP, or specialist referral.
The COVID-19 screening test can also be administered as part of a consultation with a Network GP or a specialist in private rooms. |
| 🟨 Health Assessment | Limited to 1 Health assessment per member per year is provided at a pharmacy clinic, preferably a Dis-Chem, Clicks, MediRite, or Pick n Pay pharmacy clinic.
Employer groups with more than 20 employees per location can host an on-site wellness day, during which members can undergo an annual health assessment. |
| 🟩 Employee Assistance Program | Provides counseling and support for adults, adolescents, and children.
Provides services for trauma and critical incident counseling.
Includes legal aid, credit counseling, and debt management.
Provides managerial support services.
Offers trauma and critical incident support services via telephone and on-site. |
| 🟦 Road Accident Claims | Offers assistance with vehicle accident claims (via EAP services). |
| 🟪 Workman’s Compensation Claims | Offers advice for occupational injury claims (through EAP services). |
| 🟥 Momentum Multiply Engage | Multiply Engage is free to use and provides rewards from various partners.
Members receive substantial discounts on popular brands such as Makro, Nando’s, Intercape, and FlySafair, in addition to the Multiply online store. |
| 🟧 More4Me | More4Me rewards members based on their Healthy Heart Score with monthly airtime, data, Shoprite and Checkers vouchers, or Takealot vouchers. |
Get a better understanding of Day-to-Day Benefits
Health4Me Gold Major Medical Event Benefits
✅ Accident and Emergency Cover
| 🅰️ Base | 🅱️ Standard |
| Accident Cover | Accident Cover |
| Casualty Benefits limited to R30,000 per event | Casualty Benefits limited to R30,000 per event |
| In-Hospital Benefits limited to R500,000 per event | In-Hospital Benefits limited to R1,500,000 per event |
| Emergency (Heart Attack or Stroke) Cover | Emergency (Heart Attack or Stroke) Cover |
- Accidents that meet the qualifying criteria are covered at a private hospital.
- An accident is a medical emergency caused by an external, unexpected event that is not directly or indirectly related to a member’s mental or physical health before the event.
✅ Emergency Transportation
- If an accident or emergency (heart attack or stroke) requires immediate medical treatment, emergency transportation, stabilization, and treatment are paid for.
- If the benefit limit is exceeded, the member will be taken to a state facility for treatment.
- Accident and emergency cover include emergency transportation, stabilization, and treatment costs, as well as diagnostic scans (like MRI and CT scans), take-home medication, internal and external prosthetics, orthotics, assistive devices, rehabilitation services (like step-down services, wound care, physiotherapy, and occupational therapy), subject to clinical approval and per event limits.
- Members can receive R5,000,000 per year.
✅ Accident and Emergency Cover
🅰️ Limited to R500 per day in the hospital, payable from day one, if hospitalization lasts more than 48 hours.
Limited to R20,000 per member per year.
Limited to a maximum of 40 days per year.
A maternity lump sum benefit of R10,000 is payable to a member if hospitalization is due to childbirth, regardless of the number of days the member has been hospitalized. | 🅱️ Limited to R1,000 per day in the hospital, payable from day one, if hospitalization lasts more than 48 hours.
Limited to R20,000 per member per year.
Limited to a maximum of 20 days per year.
A maternity lump sum benefit of R20,000 is payable to a member if hospitalization is due to childbirth, regardless of the number of days the member has been hospitalized. |
✅ Funeral Benefits (Including Repatriation)
| 🟥 Base | 🟧 Base | 🟩 Base | 🟥 Standard | 🟧 Standard | 🟩 Standard |
| 🟧 Cause of Death | Natural | Unnatural | 🟧 Cause of Death | Natural | Unnatural |
🟨 Principal
Spouse
Child >14 | R10,000 | R20,000 | 🟨 Principal
Spouse
Child >14 | R15,000 | R30,000 |
🟩 Children
6 – 13 years | R5,000 | R10,000 | 🟩 Children
6 – 13 years | R7,500 | R15,000 |
🟦 Children
1 – 5 years | R2,500 | R5,000 | 🟦 Children
1 – 5 years | R3,750 | R7,500 |
🟪 Children
<1 year | R1,250 | R2,500 | 🟪 Children
<1 year | R1,875 | R3,750 |
🟥 Stillborn
Babies (>28 weeks) | R750 | R1,500 | 🟥 Stillborn
Babies (>28 weeks) | R1,125 | R2,250 |
✅ Repatriation Base + Standard Plans
This benefit includes the following:
- ☑️ Road or air repatriation of mortal remains to the nearest funeral home at the usual residence.
- ☑️ Repatriation for distances over 100km within South Africa and neighboring countries (Botswana, Lesotho, Mozambique, Namibia, Swaziland, Zimbabwe).
- ☑️ Consideration of customs and beliefs.
- ☑️ Assistance with documentation and coordination with transportation authorities.
- ☑️ Transfer of ashes after cremation to the usual residence.
- ☑️ 24-hour bereavement counseling line for next of kin.
- ☑️ One-night accommodation (up to R1,000) for family members identifying the deceased or accompanying them to the funeral home.
Europ Assistance provides repatriation services 24/7, every day of the year.
Health4Me Gold Hello Doctor
Members receive complimentary access to Hello Doctor, a mobile phone-based service offering 24/7 access to doctors within minutes. Furthermore, members can also enjoy unlimited access to online/mobile health information through Hello Doctor.
Hello, Doctor consultations are unlimited and can be conducted via chat, phone, or video call (virtual) without any cost to the member. If necessary, Hello Doctor consultations include the prescription of formulary-based medications. The prescription is sent directly to the member’s nearest Dis-Chem, Clicks, MediRite, or Pick n Pay pharmacy of their choice for medication collection.
Additionally, Hello Doctor consultations encompass referrals for pathology and radiology, as per the applicable Health4Me pathology list or Health4Me radiology list.
Bloom Health4Me Gold Plan Exclusions and Waiting Periods
Bloom Health4Me Gold Plan Exclusions
An exclusion is anything your insurance does not cover, such as a specific type of medication or surgery. Exclusions will differ between plans.
However, Bloom does not publish the specific exclusions and advises prospective members to speak with a consultant to ensure they understand the exclusions in their health insurance plan.
Bloom Health4Me Gold Plan Waiting Periods
Bloom Health4Me Bronze has the following waiting periods:
- ✅ Hospital Cash and Maternity Lump Sum –
- ✅ A 3-month general waiting period
- ✅ A condition-specific 12-month waiting period for the base and standard options.
Finally, the Funeral Benefit has a 3-month waiting period for the base and standard options.
Bloom Health4Me Gold Plan vs Other Providers or Medical Aid Schemes
| 🔎 Medical Health Plan | 🥇 Bloom Health4Me Bronze | 🥈 Day1 Health Executive Comprehensive | 🥉 Clientèle Health Ultimate H.E.L.P |
| 🌎 International Cover | None | None | None |
| 👤 Main Member Contribution | R598 – R933 | R935 | R505 |
| 👥 Adult Dependent Contribution | R598 – R933 | R935 – R1,598 | R505 |
| 👶 Child Dependent Contribution | R348 – R512 | R1,263 – R2,910 | R505 |
| 🔁 Gap Cover | None | None | None |
| 📈 Screening and Prevention | ✅ Yes | None | ✅ Yes |
| 💙 Medical Savings Account | None | None | None |
| 🍼 Maternity Benefits | ✅ Yes | None | ✅ Yes |
| ➡️ Pre and Postnatal Care | ✅ Yes | None | ✅ Yes |
READ more about Fedhealth Medical Aid Scheme
Our Verdict on the Bloom Health4Me Gold Plan
The Bloom Health4Me Gold Option is a comprehensive health insurance plan offering policyholders extensive coverage. The plan covers a range of medical expenses, including chronic medication, specialist visits, additional maternity benefits (pre and postnatal), and HIV/AIDS benefits. Policyholders under the Health4Me Gold Option can benefit from chronic medication. Additionally, specialist visits are covered up to a limit of R2,440 per year.
The plan also offers comprehensive pre and postnatal maternity benefits, including preconception, antenatal, and postnatal consultations. Moreover, the Health4Me Gold Option covers the costs of HIV/AIDS testing and treatment, including antiretroviral therapy.
However, the Health4Me Gold Option comes with some drawbacks. This plan’s monthly premium is higher than Bloom’s other plans. Additionally, policyholders may be subject to waiting periods for certain benefits.
Bloom Health4Me Gold Plan Frequently Asked Questions
What chronic medication is covered under the Health4Me Gold plan?
Health4Me Gold covers 27 chronic conditions and provides insured members access to medication to manage their conditions effectively.
Can I visit a specialist under the Health4Me Gold plan?
Yes, specialist visits are covered up to a limit of R2,440 per year under the Health4Me Gold plan.
What maternity benefits are covered under the Health4Me Gold plan?
The Health4Me Gold plan offers comprehensive pre and postnatal maternity benefits, including preconception, antenatal, and postnatal consultations.
Ladies can make use of our free Ovulation Calculator
Does the Health4Me Gold plan cover HIV/AIDS testing and treatment?
Yes, the Health4Me Gold plan covers the costs of HIV/AIDS testing and treatment, including antiretroviral therapy.
What is the monthly premium for the Health4Me Gold plan?
The monthly premium for the Health4Me Gold plan is higher than other plans offered by Bloom, as it offers more comprehensive coverage. This premium ranges from R598 for the principal member, R598 for an adult-dependent/spouse, and R348 per child dependent.
Are there waiting periods for benefits under the Health4Me Gold plan?
Yes, policyholders may be subject to waiting periods for certain benefits under the Health4Me Gold plan. The waiting periods vary depending on the specific benefit, ranging from 3 to 12 months.
