Clientèle Health Ultimate H.E.L.P Plan
Overall, the Clientèle Health Ultimate H.E.L.P Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and a Premium Payback Benefit to up to 3 Family Members. The Clientèle Health Ultimate H.E.L.P Plan starts from R546 ZAR.
| 🔎 Medical Aid Plan | 🥇 Clientèle Health Ultimate H.E.L.P |
| 🌎 International Cover | None |
| 👤 Main Member Contribution | R546 |
| 👥 Adult Dependent Contribution | R546 |
| 😊 Child Dependent Contribution | R546 |
| 🔁 Gap Cover | None |
| 📉 Annual Limit | R250,000 |
| 📈 Screening and Prevention | ✅ Yes |
| 💶 Medical Savings Account | None |
| 🍼 Maternity Benefits | ✅ Yes |
Clientèle Health Ultimate H.E.L.P Plan – 7 Key Point Quick Overview
- ✅ Clientèle Health Ultimate H.E.L.P Plan Overview
- ✅ Clientèle Health Ultimate H.E.L.P Plan Monthly Premiums
- ✅ Clientèle Health Ultimate H.E.L.P Plan vs Medical Aid Plans
- ✅ Clientèle Health Ultimate H.E.L.P Plan Benefits and Cover Comprehensive Breakdown
- ✅ Clientèle Health Ultimate H.E.L.P Plan Exclusions and Waiting Periods
- ✅ Our Verdict on the Clientèle Health Ultimate H.E.L.P Plan
- ✅ Clientèle Health Ultimate H.E.L.P Plan Frequently Asked Questions
Clientèle Health Ultimate H.E.L.P Plan Overview
The Clientèle Health Ultimate H.E.L.P plan is one of 4, starting from R546. Clientèle Health Ultimate H.E.L.P Plan offers a range of benefits to policyholders, such as the Premium Payback Benefit, Cover for Children, Premium Guarantee, and more. Gap Cover is available on the Clientèle Health Ultimate 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:
Clientèle Health Ultimate H.E.L.P Plan Monthly Premiums
| 🟥 Up to 18 Years | R546 per month per policyholder (2024) |
| 🟧 18 – 35 Years | R639 per month per policyholder (2024) |
| 🟨 36 – 45 Years | R768 per month per policyholder (2024) |
| 🟩 46 – 55 Years | R1,079 per month per policyholder (2024) |
| 🟦 Up to 61 Years | R1,191 per month per policyholder (2024) |
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Clientèle Health Ultimate H.E.L.P Plan vs Medical Aid Plans
| 🔎 Medical Aid Plan | 🥇 Clientèle Health Ultimate H.E.L.P | 🥈 Discovery Health Essential Dynamic Smart | Makoti Medical Scheme – Primary Option |
| 🌎 International Cover | None | R5 million | None |
| 👤 Main Member Contribution | R546 | R1,565 | R355 – R1,034 |
| 👥 Adult Dependent Contribution | R546 | R1,565 | R355 – R805 |
| 😊 Child Dependent Contribution | R546 | R1,565 | R230 – R370 |
| 🔁 Gap Cover | None | ✅ Yes | None |
| 📉 Annual Limit | R250,000 | ✅ Yes | Unlimited hospital cover |
| 📈 Screening and Prevention | ✅ Yes | ✅ Yes | ✅ Yes |
| 💶 Medical Savings Account | None | None | None |
| 🍼 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
READ more about Medihelp Medical Aid Scheme
Clientèle Health Ultimate H.E.L.P Plan Benefits and Cover Comprehensive Breakdown
| 🟥 Daily Cash | Up to R2,500 if the member is hospitalized for more than 10 days |
| 🟧 Maximum Payment | R250,000 per year |
| 🟨 Maximum Lump Sum Pay-Out | Up to R25,000 per hospital stay, if the member is hospitalized for over 72 hours |
| 🟩 Maternity Benefit | Available |
| 🟦 Accidental Death Benefit | Up to R250,000 |
| 🟪 Accidental Disability Benefit | Up to R250,000 |
| 🟥 Dread Disease Benefit | Up to R250,000 |
| 🟧 Pre-Existing Conditions | Covered after a 12-month waiting period |
| 🟨 Premium Payback Benefit | Yes, all premiums for a deceased member are refunded with a valid death claim.
50% of premiums are returned in cash at age 65, while the remaining 50% are returned to beneficiaries upon death. |
| 🟩 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. |
Clientèle Health Ultimate H.E.L.P Plan Exclusions and Waiting Periods
Ultimate H.E.L.P 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.
Ultimate H.E.L.P 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.
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Our Verdict on the Clientèle Health Ultimate H.E.L.P Plan
The Clientèle Health Ultimate H.E.L.P Plan is a comprehensive medical aid policy offered by Clientèle Health. It provides a range of benefits to policyholders, including the Premium Payback Benefit, Cover for Children, Premium Guarantee, and more. One of the most significant benefits of the Clientèle Health Ultimate H.E.L.P Plan is the Premium Payback Benefit. This benefit allows policyholders to earn back a portion of their premiums over a five-year cycle. Furthermore, it is an excellent way for policyholders to reduce their healthcare costs while receiving top-quality medical care.
Another benefit of the policy is the Cover for Children. The policy covers dependent children under 21 or 26 if they study full-time at a recognized institution. This benefit ensures that policyholders can give their children high-quality medical care when needed. The Premium Guarantee is another valuable benefit of the Clientèle Health Ultimate H.E.L.P Plan. It guarantees that policyholders will never pay more for their medical aid premiums than the agreed-upon amount.
In addition, this benefit provides peace of mind to policyholders, knowing that their healthcare costs will not increase unexpectedly. However, there are some drawbacks to the policy. For instance, members up to 61 years old must pay higher premiums. Additionally, the policy has an age cap of 61 years, meaning that policyholders must find another medical aid provider once they reach this age. These drawbacks are significant when deciding whether to sign up for the Clientèle Health Ultimate H.E.L.P Plan.
Clientèle Health Ultimate H.E.L.P Plan Frequently Asked Questions
What is Clientèle Health Ultimate H.E.L.P Plan?
It is a comprehensive health insurance policy offered by Clientèle Health.
How does Premium Payback Benefit work in Clientèle Health Ultimate H.E.L.P Plan?
It provides policyholders with the opportunity to earn back some of the premiums that they have paid over the course of five years.
What is the age cap for Clientèle Health Ultimate H.E.L.P Plan?
Once a policyholder reaches the age limit of 61, they will no longer be covered by the policy. Instead, they will be required to locate another medical assistance provider independently.
What is Premium Guarantee in Clientèle Health Ultimate H.E.L.P Plan?
It guarantees that policyholders will never pay a higher amount for their medical aid premiums than the amount originally agreed upon.
How to sign up for Clientèle Health Ultimate H.E.L.P Plan?
You can enroll in the plan by going to the Clientèle Health website or contacting customer service. Both of these options are available to you.
What is the cost of Clientèle Health Ultimate H.E.L.P Plan?
The plan’s total cost will be determined by several factors, including the policyholder’s age, current health status, and various cover options. However, the cover starts from R546 on this plan.
What is the cover for children in Clientèle Health Ultimate H.E.L.P Plan?
Children who are financially dependent on the insured and are under the age of 21 or the age of 26 if they are enrolled full-time in an accredited educational program are covered by the insurance policy.
Can I switch to Clientèle Health Ultimate H.E.L.P Plan from another medical insurance?
Yes, you could switch from your current medical insurance to the Clientèle Health Ultimate H.E.L.P Plan. However, before making a change, you must consider the specifics of your current policy and the waiting periods you might be subject to after switching.
Does Clientèle Health Ultimate H.E.L.P Plan cover pre-existing conditions?
Several factors, including the nature and severity of the condition, will influence Clientèle Health’s decisions to cover pre-existing conditions. Therefore, it is essential to thoroughly examine the terms and conditions of the policy to ascertain whether or not your pre-existing conditions will be covered.
