Overall, the Clientèle Health Premium H.E.L.P Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and significant coverage to up to 3 Family Members. The Clientèle Health Premium H.E.L.P Plan starts from R825 ZAR.
| 🔎 Medical Health Plan | 🥇 Clientèle Health Ultimate H.E.L.P |
| 🌎 International Cover | None |
| 👤 Main Member Contribution | R825 |
| 👥 Adult Dependent Contribution | R825 |
| 👶 Child Dependent Contribution | R825 |
| 🔁 Gap Cover | None |
| 💙 Hospital Cover | ✅ Yes |
| 😷 Screening and Prevention | ✅ Yes |
| 💶 Medical Savings Account | None |
| 🍼 Maternity Benefits | ✅ Yes |
The Clientèle Health Premium H.E.L.P plan is one of 4, starting from R825 monthly. The Clientele Health Premium H.E.L.P plan is a comprehensive health insurance plan that offers significant coverage and financial protection for individuals and families in South Africa. Gap Cover is available on the Clientèle Health Premium H.E.L.P 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:
✅ Up to 61 Years: R825 per month per insured person
| 🟥 Daily Cash | Up to R3,500 if the member is hospitalized for more than 72 hours. |
| 🟧 Maximum Payment | R1,200,000 per year |
| 🟨 Maternity Benefit | Available |
| 🟩 Accidental Death Benefit | Up to R600,000 |
| 🟦 Accidental Disability Benefit | Up to R600,000 |
| 🟪 Dread Disease Benefit | Up to R300,000 |
| 🟥 Pre-Existing Conditions | Covered after a 12-month waiting period |
| 🟧 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. |
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The exclusions of the Clientele H.E.L.P Standard Plan are as follows:
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.
Here are the waiting periods for the Clientele H.E.L.P Standard Plan:
A 12-month waiting period for specific pre-existing conditions.
| 🔎 Medical Health Plan | 🥇 Clientèle Health Ultimate H.E.L.P | 🥈 Makoti Medical Scheme – Comprehensive Option | 🥉 Sizwe Hosmed Gold Ascend |
| 🌎 International Cover | None | None | Covered up to 100% of the scheme rates |
| 👤 Main Member Contribution | R825 | R2,268 – R3,101 | R3,000 |
| 👥 Adult Dependent Contribution | R825 | R1,954 – R2,657 | R2,880 |
| 👶 Child Dependent Contribution | R825 | R754 – R1,008 | R824 |
| 🔁 Gap Cover | None | None | None |
| 💙 Hospital Cover | ✅ Yes | Unlimited | Unlimited for PMBs |
| 😷 Screening and Prevention | ✅ Yes | ✅ Yes | ✅ Yes |
| 💶 Medical Savings Account | None | None | None |
| 🍼 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
READ more about Medshield Medical Scheme
The Clientele Health Premium H.E.L.P plan is a comprehensive health insurance policy that offers extensive coverage to individuals and families in South Africa. This plan provides peace of mind and financial security for unanticipated medical expenses by providing a higher annual coverage of R1.2 million. In addition, the plan provides more daily cash, which can be used to cover medical treatment-related expenses such as transportation and lodging. In addition, the Clientele Health Premium H.E.L.P. plan offers enhanced accidental death, disability, and dread disease benefits, which offer enhanced financial protection in the event of unforeseen events.
The accidental death and accidental disability benefits pay up to R600,000. In addition, the dread disease benefit can also pay up to R600,000 if the policyholder diagnoses a covered illness. However, the Clientele Health Premium H.E.L.P. plan has a few disadvantages. This plan’s premiums are higher than other health insurance options, making it difficult for some individuals and families to afford. In addition, the plan does not offer a lump sum payout, which may be a disadvantage for individuals who prefer this type of coverage. Finally, this plan does not include a Premium Waiver, so the policyholder must continue paying premiums even if they cannot work due to illness or injury.
The Dread Disease Benefit is a feature of the Clientele Health Premium H.E.L.P. plan that covers critical illnesses such as cancer, heart attack, and stroke. Suppose you are diagnosed with a covered illness. In that case, the benefit can be up to R600,000, which can be used to cover medical expenses and other costs.
The Clientele Health Premium H.E.L.P plan’s Disability Cover can pay up to R600,000 if you become permanently disabled due to an illness or injury. This can help cover medical bills, rehabilitation, and living expenses.
The Accidental Death Benefit is a feature of the Clientele Health Premium H.E.L.P. plan that pays up to R600,000 in the event of an accident-related death. This benefit can financially assist the policyholder’s family during a calamity.
Depending on the selected plan, the Daily Cash Benefit provided by the Clientele Health Premium H.E.L.P. plan varies. However, the plan may provide up to R3,500 per day in cash benefits for each day of hospitalization or outpatient treatment.
The Clientele Health Premium H.E.L.P plan provides annual coverage of up to R1.2 million, which can help cover unanticipated medical expenses and provide financial security for your family.
The Clientele Health Premium H.E.L.P plan’s premiums vary based on the level of coverage you select, your age, and other variables. Due to its comprehensive coverage and additional benefits, this plan’s premiums are generally higher than other health insurance policies. However, before deciding if a plan is a good fit for you, it is crucial to examine the plan’s details and premiums thoroughly.
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.
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