Oneplan Health Professional Plan

 

Overall, the Oneplan Health Professional Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and higher annual limits to up to 3 Family Members. The Oneplan Health Professional Plan starts from R1,330 ZAR.

 

🔎 Medical Plan	Oneplan Health Professional
👤 Main Member Contribution	R1,330
👥 Adult Dependent Contribution	R2,540 for a couple
🍼 Child Dependent Contribution	R2,125 (Single adult + 1 Child) – R3,105 (Couple + 1 child)
🔁 Gap Cover	None
🏥 Hospital Cover	✅ Yes
💵 Prescribed Minimum Benefits (PMB)	✅ Yes
😷 Screening and Prevention	None
💶 Medical Savings Account	None
📉 Annual Limit	R12,490 – R520,000

 

 

 

Oneplan Health Professional Plan – 7 Key Point Quick Overview

 

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

 

 

Oneplan Health Professional Plan Overview

 

The Oneplan Health Professional Plan is one of 4, starting from R1,330 and includes additional cover not included on the Core and Blue plans, in addition to specialist visits and higher annual limits on treatment and services. Gap Cover is not available on the Oneplan Health Professional 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 Professional Plan Premiums

 

🟥 Family Dynamic	💴 Monthly Premium
🟧 Single Member	R1,330
🟨 Single Insured +1 Child	R2,125
🟩 Single Insured +2 Children	R2,785
🟦 Single Insured +3 Children	R3,370
🟪 Single Insured +4 Children	R3,950
🟥 Couple	R2,540
🟧 Couple Insured +1 Child	R3,105
🟨 Couple Insured +2 Children	R3,610
🟩 Couple Insured +3 Children	R4,105
🟦 Couple Insured +4 Children	R4,535

 

READ more about Health & Medical Insurance

 

 

Oneplan Health Professional Plan vs Other Providers or Medical Aid Schemes

 

🔎 Medical Plan	Oneplan Health Professional	Fedhealth MyFED	Medihelp MedMove!
👤 Main Member Contribution	R1,330	R1,590 – R4,676	R1,476
👥 Adult Dependent Contribution	R2,540 for a couple	R1,590 – R4,260	R1,476
🍼 Child Dependent Contribution	R2,125 (Single adult + 1 Child) – R3,105 (Couple + 1 child)	R677 – R1,782	R1,476
🔁 Gap Cover	None	None	None
🏥 Hospital Cover	✅ Yes	Unlimited	Unlimited
💵 Prescribed Minimum Benefits (PMB)	✅ Yes	✅ Yes	✅ Yes
😷 Screening and Prevention	None	✅ Yes	✅ Yes
💶 Medical Savings Account	None	✅ Yes	None
📉 Annual Limit	R12,490 – R520,00	No Overall Annual Limit	Unlimited Hospital Cover

 

Poll: 5 Best Hospital Plans under R300

 

 

Oneplan Health Professional Plan Benefits and Cover Comprehensive Breakdown

 

Professional Plan Health Cover

 

🔴 Doctor’s Visits	Limited to R475 per visit. Limited to R2,515 annually per single policyholder. Limited to R5,025 annually per family (2 – 3 dependents). Limited to R6,285 annually per family (4> dependents). Subject to a 30-day waiting period.
🟠 Scripted Medication	Limited to R275 per script. Limited to R1,090 annually per single policyholder. Limited to R1,585 annually per family (2 – 3 dependents). Limited to R2,110 annually per family (4> dependents). Subject to a 30-day waiting period.
🟡 Over-the-Counter Medication	Limited to R275 per year. Limited to R275 annually per single policyholder. Limited to R820 annually per family (2 – 3 dependents). Limited to R1,090 annually per family (4> dependents). Subject to a 30-day waiting period.
🟢 Pathology	Limited to R555 per event Limited to R2,225 annually per single policyholder. Limited to R3,890 annually per family (2 – 3 dependents). Limited to R5,010 annually per family (4> dependents). Subject to a 30-day waiting period. Requires a doctor’s referral.
🔵 Basic Radiology	Limited to R555 per event Limited to R2,225 annually per single policyholder. Limited to R3,890 annually per family (2 – 3 dependents). Limited to R5,010 annually per family (4> dependents). Subject to a 30-day waiting period. Requires a doctor’s referral.
🟣 Dentistry	Limited to R810 per visit, up to 3 visits per year. Limited to R2,435 annually per single policyholder. Limited to R4,060 annually per family (2 – 3 dependents). Limited to R5,670 annually per family (4> dependents). Subject to a 90-day waiting period.
🔴 Maternity Pre-birth Benefit	Limited to R665 per visit, up to 3 visits per pregnancy. Overall annual limit of R2,000. All new policies have a 7-month waiting period followed by a 4-month waiting period from conception.
🟠 Optometry	Limited to R1,595, with benefits available after two years from the service date. Subject to a 12-month waiting period.

 

Professional Plan Hospital Risk Cover

 

❤️ Casualty Illness	Limited to R5,800 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 R5,800 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 R260,000 per insured event. Limited to R520,000 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 R68,000 per insured event per person. Limited to R170,000 per insured annually. A 90-day waiting period applies. Certain conditions will be subject to a 12-month waiting period.
💙 Dread Disease	Limited to R335,000 per defined disease annually. A 6-month waiting period will apply.
💜 Natural Birth and Emergency Caesareans	Limited to R65,000 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 R65,000 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.

 

Professional Plan Additional Benefits

 

🖤 Accidental Disability	Limited to R230,000 for the duration of the policy. Limited to the principal insured policyholder.
☠️ Family Death Cover	Limited to R20,000 for the principal insured member. Limited to R20,000 for the Spouse/Partner. Limited to R20,000 for every child between 14 and 21 years. Limited to R12,500 per child between 6 to 13 years. Limited to R8,750 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.

 

Read more about the 5 Best Comprehensive Medical Aid Plans

 

 

Oneplan Health Professional Plan Exclusions and Waiting Periods

 

Oneplan Health Professional Plan Exclusions

 

Oneplan Health Professional 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 Professional 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)	90-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

 

Discover more about Medical Aids

 

 

Our Verdict on the Oneplan Health Professional Plan

 

Overall, the Oneplan Health Professional plan is a comprehensive medical insurance plan that offers more benefits than the Blue and Core plans but does not include specialist consultations. The plan is designed for individuals and families who require more medical coverage, particularly for illnesses and accidents.

 

Some of the unique features of the Oneplan Health Professional plan include unlimited private hospitalization coverage, unlimited casualty benefit cover, and unlimited coverage for MRI, CT, and PET scans.  The plan also covers chronic medication for 27 listed conditions. In addition, Oneplan Health Professional offers additional benefits such as dental and optometry coverage, maternity benefits, and emergency medical transportation.

 

The plan provides a range of benefits, making it an attractive option for those requiring more comprehensive medical coverage. However, individuals who require specialist consultations may need to consider other options, as this plan does not cover such consultations.

 

 

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

 

 

Oneplan Health Professional Plan Frequently Asked Questions

 

What is the Oneplan Health Professional plan?

Oneplan Health Professional is a comprehensive medical insurance plan that offers more benefits than the Blue and Core plans but does not include specialist consultations.

 

What does the Oneplan Health Professional plan cover?

Oneplan Health Professional covers unlimited private hospitalization, chronic medication for 27 listed conditions, dental and optometry cover, maternity benefits, emergency medical transportation, and more.

 

Does the Oneplan Health Professional plan cover specialist consultations?

No, Oneplan Health Professional does not include specialist consultations.

 

What is the difference between the Oneplan Health Professional and Blue plans?

The Oneplan Health Professional plan offers more benefits, including unlimited private hospitalization and chronic medication coverage, but does not include specialist consultations.

 

Who is the Oneplan Health Professional plan ideal for?

Oneplan Health Professional is designed for individuals and families who require more medical coverage, particularly for illnesses and accidents.

 

How much does the Oneplan Health Professional plan cost?

The cost varies depending on the number of individuals covered and the selected benefits. However, Oneplan Health Professional starts from R1,210 for the main (single) policyholder.

 

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

Oneplan Health Professional will cover pre-existing conditions but is subject to certain conditions and waiting periods.

 

Does the Oneplan Health Professional plan cover dental and optometry?

Yes, Oneplan Health Professional offers dental and optometry cover of up to R810 and R1,595, respectively.

 

Can I choose my own hospital with the Oneplan Health Professional plan?

Yes, you can choose your own private hospital with the plan.

 

Does the Oneplan Health Professional plan cover emergency medical transportation?

Yes, Oneplan Health Professional offers emergency medical transportation coverage.