Oneplan Health Blue Plan

 

Overall, the Oneplan Health Blue Plan is a trustworthy and comprehensive health insurance plan that offers 24/7 medical emergency assistance and Prescribed Minimum Benefits to up to 3 Family Members. The Oneplan Health Blue Plan starts from R955 ZAR.

 

🔎 Health Insurance Plan	🥇 Oneplan Health Blue
👤 Main Member Contribution	R955
👥 Adult Dependent Contribution	R1,835 for a couple
🥰 Child Dependent Contribution	R1,505 (Single adult + 1 Child) – R2,380 (Couple + 1 child)
🔁 Gap Cover	None
📈 Annual Limit	R8,650 – R460,000
💶 Prescribed Minimum Benefits	✅ Yes
😷 Screening and Prevention	None
💵 Medical Savings Account	None
🍼 Maternity Benefits	✅ Yes

 

 

 

Oneplan Health Blue Plan – 7 Key Point Quick Overview

 

1. ✅ Oneplan Health Blue Plan Overview
2. ✅ Oneplan Health Blue Plan Premiums
3. ✅ Oneplan Health Blue Plan Benefits and Cover Comprehensive Breakdown
4. ✅ Oneplan Health Blue Plan Exclusions and Waiting Periods
5. ✅ Oneplan Health Blue Plan vs Other Providers or Medical Aid Schemes
6. ✅ Our Verdict on the Oneplan Health Blue Plan
7. ✅ Oneplan Health Blue Plan Frequently Asked Questions

 

 

Oneplan Health Blue Plan Overview

 

The Oneplan Health Blue Plan is one of 4, starting from R955 and includes cover for dentistry, dread diseases, natural births and emergency caesareans, trauma counseling, and more.  Gap Cover is not available on the Oneplan Health Blue Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Oneplan Health has a trust rating of 9.9.

 

Oneplan Health Insurance has the following four plans to choose from:

 

✅ Oneplan Health Blue Plan
✅ Oneplan Health Core Plan
✅ Oneplan Health Executive Plan
✅ Oneplan Health Professional Plan

 

 

 

Oneplan Health Blue Plan Premiums

 

🟥 Family Dynamic	💵 Monthly Premium
🟧 Single Member	R955
🟨 Single Insured +1 Child	R1,505
🟩 Single Insured +2 Children	R2,055
🟦 Single Insured +3 Children	R2,590
🟪 Single Insured +4 Children	R3,110
🟥 Couple	R1,835
🟧 Couple Insured +1 Child	R2,380
🟨 Couple Insured +2 Children	R2,810
🟩 Couple Insured +3 Children	R3,215
🟦 Couple Insured +4 Children	R3,595

 

POLL: 3 Best Hospital Plans Under R1000

 

 

Oneplan Health Blue Plan Benefits and Cover Comprehensive Breakdown

 

Blue Plan Health Cover

 

👨‍⚕️ Doctor’s Visits	Limited to R420 per visit. Limited to R2,135 annually per single policyholder. Limited to R3,835 annually per family (2 – 3 dependents). Limited to R5,110 annually per family (4> dependents). Subject to a 30-day waiting period.
💉 Scripted Medication	Limited to R190 per script. Limited to R755 annually per single policyholder. Limited to R1,100 annually per family (2 – 3 dependents). Limited to R1,465 annually per family (4> dependents). Subject to a 30-day waiting period.
💊 Over-the-Counter Medication	Limited to R190 per year. Limited to R190 annually per single policyholder. Limited to R570 annually per family (2 – 3 dependents). Limited to R755 annually per family (4> dependents). Subject to a 30-day waiting period.
🧪 Pathology	Limited to R505 per event Limited to R1,675 annually per single policyholder. Limited to R3,360 annually per family (2 – 3 dependents). Limited to R4,620 annually per family (4> dependents). Subject to a 30-day waiting period. Requires a doctor’s referral.
🧬 Basic Radiology	Limited to R505 per event Limited to R1,675 annually per single policyholder. Limited to R3,360 annually per family (2 – 3 dependents). Limited to R4,620 annually per family (4> dependents). Subject to a 30-day waiting period. Requires a doctor’s referral.
🦷 Basic Dentistry	Limited to R685 per visit, up to 3 visits per year. Limited to R1,695 annually per single policyholder. Limited to R3,160 annually per family (2 – 3 dependents). Limited to R4,235 annually per family (4> dependents). Subject to a 90-day waiting period.
🍼 Maternity Pre-birth Benefit	Limited to R660 per visit, up to 3 visits per pregnancy. Overall annual limit of R1,985 All new policies have a 7-month waiting period followed by a 4-month waiting period from conception.
😎 Optometry	Limited to R1,215 with benefits available after two years from the service date. Subject to a 12-month waiting period.

 

Blue Plan Hospital Risk Cover

 

⚠️ Casualty Illness	Limited to R5,600 for all life-threatening illnesses in an emergency or casualty room. There is a 3-month waiting period that applies. There is an excess payable.
🤕 Casualty Accident	Limited to R5,600 for accidents and covers treatment in casualty units that will not result in admission. Immediately available. There is an excess payable.
🩹 Accident Cover	Limited to R230,000 per insured event. Limited to R460,000 per family per year. The cover is immediate. However, contact sport has a 12-month waiting period. There is an excess payable.
🏥 Illness in Hospital	Limited to R60,000 per insured event per person. Limited to R150,000 per insured annually. A 90-day waiting period applies. Certain conditions will be subject to a 12-month waiting period.
🤧 Dread Disease	Limited to R315,000 per defined disease annually. A 6-month waiting period will apply.
👶 Natural Birth and Emergency Caesareans	Limited to R55,000 per insured event per person. The cover is subject to illness and operations’ annual limits. A 12-month waiting period will apply.
🤰 Neonatal Benefits	Limited to R55,000 per insured event per person. The cover is subject to the illness and operations’ overall limit. There is a 12-month waiting period that applies. The benefit includes coverage within the first 4 weeks from birth.
📌 Repatriation	Limited to R15,000 per insured person and includes repatriation of mortal remains to the funeral home. The cover is available immediately.
🚑 Ambulance and Emergency Services	The cover is available immediately and includes 24-hour Medical Assistance. The insured will be transported by ambulance to the closest appropriate medical facility if a life-threatening medical emergency occurs.

 

Blue Plan Additional Benefits

 

❤️ Accidental Disability	Limited to R220,000 for the duration of the policy. Limited to the principal insured policyholder.
🖤 Family Death Cover	Limited to R15,000 for the principal insured member. Limited to R15,000 for the Spouse/Partner. Limited to R15,000 for every child between 14 and 21 years. Limited to R10,000 per child between 6 to 13 years. Limited to R7,500 per child between 1 to 5 years.
🤍 Trauma, Assault, and Accidental HIV	Includes trauma and assault counseling, accidental HIV protection services, and Accidental HIV infection treatment.

 

Discover more about the 5 Best Medical Aid for Unemployed in South Africa

 

 

Oneplan Health Blue Plan Exclusions and Waiting Periods

 

Oneplan Health Blue Plan Exclusions

 

Oneplan Health Blue Plan exclusions include, but are not limited to, the following:

 

• ✅ Nuclear weapons, nuclear material, ionizing radiation, or contamination by radioactivity from nuclear fuel or waste from nuclear fuel combustion.
• ✅ War, invasion, an act of a foreign enemy, hostilities, warlike operations, civil war, mutiny, military rising, martial law, state of siege, insurrection, rebellion, or revolution.
• ✅ Cost of operations, treatments, and procedures that are not medically justifiable, i.e. all other lines of conservative treatment, must first be considered.
• ✅ Cosmetic procedures such as breast augmentation, gastroplasty, gender reversal operations, etc.
• ✅ Costs incurred for tests and examinations requested for immigration, emigration, visas, insurance policies, employment, admission to schools and universities, court medical reports, muscle-function tests, fitness examinations, and tests for adopting children and retirement because of ill health.
• ✅ Costs incurred for the treatment of obesity and health holidays.
• ✅ Purchase of certain items such as bandages, cotton wool, and plasters on prescription not used in practitioners’ rooms, food substitutes, food supplements and patent food, incontinence supplies, diabetic strips, and other diabetic consumables, stoma care products, home pregnancy test kits, slimming products and appetite suppressants, prescribed toothpaste, mouthwashes, and ointments for oral hygiene, toiletries and beauty preparations, contraceptives, and medical appliances.
• ✅ Participation in civil commotion, labor disturbances, riots, strikes, or the activities of locked-out workers.

 

Participation in any race or speed test other than on foot or non-mechanically propelled watercraft, and more.

 

Oneplan Health Blue Plan Waiting Periods

 

Oneplan Health has the following waiting periods:

 

🔴 Doctor’s Visits	30-day waiting period
🟠 Scripted Medication	30-day waiting period
🟡 Over-the-Counter Medication	30-day waiting period
🟢 Pathology	30-day waiting period
🔵 Radiology	30-day waiting period
🟣 Dentistry	30-day waiting period
🔴 Specialist Cover (not available on Blue)	30-day waiting period
🟠 Maternity Pre-Birth	11 months (7 months for new policies, 4 months from date of conception)
🟡 Optometry	12-month waiting period
🟢 Casualty Illness	90-day waiting period
🔵 Casualty Accident	No waiting period
🟣 Accident Cover	No waiting period
🔴 Illness in Hospital	90-day waiting period
🟠 Dread Disease	6-month waiting period
🟡 Natural Birth and Emergency Caesareans	12-month waiting period
🟢 Neonatal	12-month waiting period
🔵 Repatriation	No waiting period
🟣 Ambulance and Emergency Services	No waiting period
🔴 Accidental Disability	No waiting period
🟠 Family Death Cover	No waiting period
🟡 Trauma, Assault, and Accidental HIV	No waiting period
🟢 Excess Buster	No waiting period

 

READ more about Hospital Plans

 

 

Oneplan Health Blue Plan vs Other Providers or Medical Aid Schemes

 

🔎 Health Insurance Plan	🥇 Oneplan Health Blue	🥈 Clientèle Health Ultimate H.E.L.P	🥉 Momentum Ingwe Plan
👤 Main Member Contribution	R955	R546	R541
👥 Adult Dependent Contribution	R1,835 for a couple	R546	R541
🥰 Child Dependent Contribution	R1,505 (Single adult + 1 Child) – R2,380 (Couple + 1 child)	R546	R541
🔁 Gap Cover	None	None	✅ Yes
📈 Annual Limit	R8,650 – R460,000	R250,000	None
💶 Prescribed Minimum Benefits	✅ Yes	✅ Yes	✅ Yes
😷 Screening and Prevention	None	✅ Yes	✅ Yes
💵 Medical Savings Account	None	None	None
🍼 Maternity Benefits	✅ Yes	✅ Yes	✅ Yes

 

 

Our Verdict on the Oneplan Health Blue Plan

 

Oneplan Health Blue Plan is a comprehensive medical insurance policy offering a range of benefits to cover medical expenses that policyholders incur. The policy offers a combination of hospital cover, outpatient cover, and day-to-day benefits, including unlimited GP consultations and basic dentistry.

 

The policy covers medical expenses such as hospitalization, emergency medical treatment, specialist consultations, and prescribed medication. Furthermore, the policy also covers dread diseases such as cancer and heart disease. It provides a cash lump sum payout upon diagnosis of these conditions.

 

However, the policy has certain limitations and exclusions that may affect the scope of coverage. For example, pre-existing conditions have a waiting period, and certain conditions are not covered under the policy, such as cosmetic surgery and infertility treatment.

 

The policy also limits some benefits, such as casualty cover, which is limited to R5,600 per event.  Furthermore, the policy document specifies that the policy will not cover expenses incurred outside of South Africa, and there are limitations on the coverage of chronic medication. The policy also has certain age restrictions for benefits such as maternity and wellness programs.

 

 

• You might also like: Oneplan Health Core Plan
• You might also like: Oneplan Health Executive Plan
• You might also like: Oneplan Health Professional Plan
• You might also like: Oneplan Health Insurance Review

 

 

Oneplan Health Blue Plan Frequently Asked Questions

 

What is the Oneplan Health Blue plan?

The Oneplan Health Blue plan is a more comprehensive health insurance plan that covers a range of healthcare services, including GP visits, hospital cover, and prescribed medication benefits. Furthermore, Oneplan Health Blue is designed as an affordable option for people who want access to quality healthcare without breaking the bank.

 

What does the Oneplan Health Blue plan cover?

The Oneplan Health Blue plan covers a range of healthcare services, including dentistry, pathology, radiology, casualty illness, dread diseases, accidents, and more.

 

How much does the Oneplan Health Blue plan cost?

The cost of the Oneplan Health Blue plan depends on several factors. However, it starts from R955 per single policyholder/insured person. The cost of this plan is determined by your family dynamic and how many dependents you add.

 

Can I choose my doctor with the Oneplan Health Blue plan?

Yes, with the Oneplan Health Blue plan, you can choose your own GP. There are no restrictions on which doctors you can see. However, you might require a doctor’s referral for benefits such as radiology and pathology.

 

Is dental and optical cover included in the Oneplan Health Blue plan?

Yes, the Oneplan Health Blue plan includes dental and optical benefits. This includes cover for routine check-ups, fillings, extractions, and other dental procedures, as well as eye tests, frames, and lenses.

 

Does the Oneplan Health Blue plan cover pre-existing conditions?

The Oneplan Health Blue plan does not cover pre-existing conditions for the first 12 months of membership. After this waiting period, cover for pre-existing conditions is provided, subject to certain terms and conditions.