Clientèle Health Accident Plus Plan
Overall, the Clientèle Health Accident Plus Plan is a trustworthy and comprehensive medical insurance plan that offers 24/7 medical emergency assistance and affordable accident coverage to up to 3 Family Members. The Clientèle Health Accident Plus Plan starts from R406 ZAR.
| 🔎 Medical Insurance Plan | 🥇 Clientèle Health Accident Plus Plan |
| 👤 Main Member Contribution | R406 |
| 👥 Adult Dependent Contribution | R406 |
| 🍼 Child Dependent Contribution | R406 |
| 🔁 Gap Cover | None |
| 📉 Annual Limit | R250,000 |
| 😷 Screening and Prevention | None |
| 💶 Medical Savings Account | None |
| 🏥 Hospital Cover | None |
| 🦷 Dentistry Benefit | None |
Clientèle Health Accident Plus Plan Overview – 7 Key Point Quick Overview
- ✅ Clientèle Health Accident Plus Plan Overview
- ✅ Clientèle Health Accident Plus Plan Monthly Premiums
- ✅ Clientèle Health Accident Plus Plan Benefits and Cover Comprehensive Breakdown
- ✅ Clientèle Health Accident Plus Plan Exclusions and Waiting Periods
- ✅ Clientèle Health Accident Plus Plan vs Medical Aid Plans
- ✅ Our Verdict on the Clientèle Health Accident Plus Plan
- ✅ Clientèle Health Accident Plus Plan Frequently Asked Questions
Clientèle Health Accident Plus Plan Overview
The Clientèle Health Accident Plus plan is one of 4, starting from R406 monthly. The Clientele Health Accident Plus plan provides a good option for individuals who want affordable accident coverage without having to pay for the extras that come with a comprehensive health insurance policy. Gap Cover is available on the Clientèle Health Accident Plus Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Clientèle Health has a trust rating of 8.5.
Clientèle Health has the following four plans:
Clientèle Health Accident Plus Plan Monthly Premiums
Up to 61 Years: R406 per month per insured person
Clientèle Health Accident Plus Plan Benefits and Cover Comprehensive Breakdown
| 💶 Daily Cash | Up to R2,500 if the member is hospitalized for more than 72 hours. |
| 💵 Maximum Payment | R250,000 per year |
| Accidental Death Benefit | R250,000 per year |
| 💴 Accidental Disability Benefit | R250,000 per year |
| 💷 Dread Disease Benefit | R250,000 per year |
| ⚠️ Pre-Existing Conditions | Covered after a 12-month waiting period |
| 4️⃣ Number of Children Covered | 4 – no extra cost |
| 🍼 Children Cover | The benefits for children covered by this policy are subject to limitations.
In addition, cover for children under six is capped at R10,000 per year, and cover for children between the ages of six and thirteen is capped at R30,000 per year. |
| 📈 Inflation Protection | Each year, the premiums and benefits will be evaluated and adjusted accordingly, with increases taking effect on January 1st.
Statistics South Africa reports that the annual inflation rate will determine the increased amount. |
| 🏅 Premium Guarantee | The premiums may change annually and will be assessed by December 1st of each year.
Members will be notified of any premium increases. |
You might consider the 5 Best Gap Cover Options for Under R1 000
Clientèle Health Accident Plus Plan Exclusions and Waiting Periods
Accident Plus Plan Exclusions
The exclusions of the Clientele H.E.L.P Standard Plan are as follows:
- Hospitalization that has not been authorized by Clientele or when reasonable notification has not been received.
- Hospitalization or treatment received for conditions excluded as per policy terms and conditions.
- Hospitalization is not recommended by a medical specialist.
- Hospitalization during a month when the premium has not been received.
- Hospitalization lasts for 3 days or less (except for maternity claims).
- Hospitalization due to illness during the waiting period.
- Claims that are fraudulent or exaggerated in any way.
- Hospitalization in a facility that does not meet the Clientele’s definition of a hospital.
- Hospitalization is related to an illness where the length of stay exceeds the recommended number of days for such conditions, as per limits of coverage and definitions.
Accident Plus Plan Waiting Periods
Here are the waiting periods for the Clientele H.E.L.P Standard Plan:
- No waiting period for hospitalization due to an accident.
- A 3-month waiting period for illness.
- A 6-month waiting period for the dread disease.
- A 12-month waiting period for maternity benefits.
A 12-month waiting period for specific pre-existing conditions.
Clientèle Health Accident Plus Plan vs Medical Aid Plans
| 🔎 Medical Insurance Plan | 🥇 Clientèle Health Ultimate H.E.L.P | 🥈 Fedhealth FlexiFED Savvy | 🥉 Makoti Medical Scheme Primary Option |
| 👤 Main Member Contribution | R406 | R965 | R355 – R1,034 |
| 👥 Adult Dependent Contribution | R406 | R965 | R355 – R805 |
| 🍼 Child Dependent Contribution | R406 | R709 | R230 – R370 |
| 🔁 Gap Cover | None | None | None |
| 📉 Annual Limit | R250,000 | Unlimited Hospital Cover | Unlimited hospital cover |
| 😷 Screening and Prevention | None | ✅ Yes | ✅ Yes |
| 💶 Medical Savings Account | None | ✅ Yes | None |
| 🏥 Hospital Cover | None | Unlimited | Unlimited |
| 🦷 Dentistry Benefit | None | Only in-hospital | ✅ Yes |
READ more about Momentum Health
Our Verdict on the Clientèle Health Accident Plus Plan
The Clientele Health Accident Plus plan is a purely accidental cover policy that provides up to R250,000 annual cover for accidents in and out-of-hospital, subject to terms and conditions. The plan offers a range of benefits, including accidental death and disability cover, hospital cash benefits, and emergency transportation. However, the policy does not cover maternity, PMB, chronic medicine, optometry, or any other essentials typically covered by health insurance. The accidental death benefit pays out a lump sum of up to R250,000 in the event of the policyholder’s accidental death. The accidental disability benefit provides financial support in case of permanent disability resulting from an accident.
The hospital cash benefit pays out a daily amount for each day the policyholder is in the hospital due to an accident, up to a maximum of 365 days per event. The emergency transportation benefit covers the cost of transportation to the nearest hospital in an emergency. One of the drawbacks of the Clientele Health Accident Plus plan is that it does not cover any medical expenses that are not directly related to an accident. Unfortunately, routine healthcare needs such as GP visits, medication, and optometry are not covered. Additionally, the policy only covers accidental injuries and does not provide any cover for illnesses.
Clientèle Health Accident Plus Plan Frequently Asked Questions
What is the Clientele Health Accident Plus Plan?
The Clientele Health Accident Plus Plan is a health insurance policy covering accidental injuries, including death and disability, cash benefits for hospitals, and emergency transportation.
What does the Clientele Health Accident Plus Plan cover?
The cover includes accidental death and disability, hospital cash benefits, and emergency transportation. However, it does not cover medical costs unrelated to an accident, such as doctor’s visits, prescriptions, and optometry.
How much annual cover does the Clientele Health Accident Plus Plan provide?
The plan covers up to R250,000 per year for in- and out-of-hospital accidents, subject to terms and conditions.
What is the accidental death benefit of the Clientele Health Accident Plus Plan?
The accidental death benefit pays a lump sum of up to R250,000 in the event of the policyholder’s death.
Does the Clientele Health Accident Plus Plan cover chronic illnesses?
No, the plan covers only accidental injuries and excludes coverage for illnesses.
Are there any exclusions to the Clientele Health Accident Plus Plan?
Yes, apart from general exclusions, the policy does not cover maternity, PMB, chronic medicine, optometry, or any other typically covered essentials. Also excluded are medical costs not directly related to an accident.
