Stratum Benefits Health Insurance (🇿🇦 2025)
Overall, Stratum Benefits is a trustworthy and comprehensive health insurance provider that offers 24/7 medical emergency support and Chronic Illness Benefits to each Family Member. The Stratum Benefits Health Insurance Plans start from R195 ZAR. Stratum Benefits has a trust score of 4.1.
💙Stratum Benefits Health Insurance has the following four plans to choose from:
✅ Stratum Benefits Corporate Essential Day-to-Day Plan
✅ Stratum Benefits Corporate Essential Emergency/Accident Plan
✅ Stratum Benefits Essential Primary Plus Day-to-Day Plan
✅ Stratum Benefits Essential Primary Plus Emergency/Accident Plan
| 📌 The average number of members | 10,000+ |
| 1️⃣ Number of Markets | 1 |
| 👤 Number of Employees | 500+ |
| 4️⃣ Average Customer Rating | 4.1 |
| 💯 Average Number of Reviews | 870+ |
| 📊 Market Share | 5%> |
| 4️⃣ The number of plans offered | 4 |
| 🏥 Number of Hospitals in Network | 150+ |
| 📱 Mobile App | ✅ Yes |
| 💻 Medical Claims Portal | ✅ Yes |
| 😷 Information Hub for COVID-19 | ✅ Yes |
| 🤧 Chronic Illness Benefits | ✅ Yes |
| 🤕 Number of PMB Diagnoses | 271 |
| 💊 Number of PMB Chronic Conditions | 9 |
| 🩺 Screening and Prevention offered | ✅ Yes |
| 🍼 Maternity Benefit | ✅ Yes |
| 💵 Monthly Premium Range | R195 – R656 |
| ⚠️ Average Waiting Period | 3 – 12 months |
Stratum Benefits – Analysis of Insurers’ Main Features
- ✅ Stratum Benefits Plan Overview
- ✅ Stratum Benefits – Advantages over Competitors
- ✅ How to apply for Health Insurance with Stratum Benefits
- ✅ Overview of Stratum Benefits Gap cover
- ✅ How to apply for Gap Cover with Stratum Benefits
- ✅ How to Submit a Claim with Stratum Benefits
- ✅ How to Submit a Compliment or Complaint with Stratum Benefits
- ✅ How to Switch My Health Insurance to Stratum Benefits
- ✅ Stratum Benefits Customer Support
- ✅ Stratum Benefits vs Notable Competitors – A Comparison
- ✅ Stratum Benefits Customer Reviews
- ✅ Stratum Benefits Pros and Cons
- ✅ Our Verdict on Stratum Benefits
- ✅ Stratum Benefits Frequently Asked Questions
Stratum Benefits Plan Overview
One of the Best Health Insurance Options in South Africa
Stratum Benefits Primary Plus and Corporate Day-to-Day Benefit
✅ Stratum Benefits Contributions
| 🔎 Eligible Age | 👤 Principle Member | 👥 Spouse | 💙 Adult Dependent | 🍼 Child Dependent |
| <55 Years | R435 | R345 | R345 | R139 |
| 56 Years> | R656 | R566 | R566 | n/a |
In terms of the Corporate Plan, the employer group premiums are determined by factors such as the size of the employer group, average age, and whether coverage is mandatory or voluntary.
✅ Stratum Benefits – Benefits Overview
💙The Day-to-Day benefits for Primary Plus and Corporate options include the following benefits:
- ✅Consultation cover
- ✅GP consultations and medical procedures
- ✅Out-of-network GP consultations
- ✅Telemedicine GP consultations
- ✅Intercare online GP consultations
- ✅Nurse consultations
- ✅Specialist consultations
- ✅Pre-birth consultations
- ✅Acute medication
- ✅Chronic medication
and many more.
Stratum Benefits Primary Plus and Corporate Emergency and Accident Benefit
✅ Stratum Benefits Contributions
| 🔎 Eligible Age | 👤 Principle Member | 👥 Spouse | 💙 Adult Dependent | 🍼 Child Dependent |
| <55 or younger | R195 | R119 | R119 | R56 |
| 56 or older> | R251 | R175 | R175 | n/a |
In terms of the Corporate Plan, the employer group premiums are determined by factors such as the size of the employer group, average age, and whether coverage is mandatory or voluntary.
✅ Stratum Benefits – Benefits Overview
💙The Emergency and Accident benefits for Primary Plus and Corporate options include the following cover:
- ✅Hospital care
- ✅Emergency cover
- ✅Accident cover
- ✅Casualty accident cover
- ✅MRI and CT scans
- ✅Physio and occupational therapy
- ✅24-hour medical emergency services
- ✅Accidental death
- ✅Essential Assistance Program (EAP)
- ✅Extra high school learning support
A full Emergency and Accident benefit list will be supplied by Stratum Benefits.
💙Read more about Health Care Insurance / Private Medical Insurance
Medical Insurance Stratum Benefits – Advantages over Competitors
💙The advantages of choosing Stratum Benefits include the following:
- ✅ Availability of a variety of medical aid gap cover products to suit individual needs and budgets.
- ✅ A claims process that is efficient and streamlined, with payments made directly to healthcare providers.
- ✅ Comprehensive cover for in-hospital and out-of-hospital medical expenses, including coverage for chronic medications and specialized procedures like MRI and CT scans.
- ✅ Telemedicine consultations with qualified medical professionals are available for added convenience and cost savings.
- ✅ Agents with extensive knowledge and experience who go above and beyond to assist customers.
- ✅ Access to a variety of professional services, including legal and financial advice, trauma counseling, and HIV management, is provided by the Essential Assistance Programme (EAP).
- ✅ Extra High School Learning Support provides academically challenged students with specialized assistance and resources.
- ✅ Regular communication and updates on policy changes and benefits ensure peace of mind and openness.
Affordable premiums and flexible payment options to accommodate various financial circumstances.
💙READ MORE: Health Insurance for Kids
How to apply for Health Insurance with Stratum Benefits
💙To apply for Health Insurance through Stratum Benefits, you can follow the following steps:
- ✅ Visit the Stratum Benefits website at www.stratumbenefits.co.za. On the homepage, you will find several options for different types of health insurance coverage. However, new members should note that they can only choose from the Primary Care options as an individual applying.
- ✅ If you are unsure which type of cover is right for you, click the “Get a Quote” button to receive a personalized quote based on your needs and budget. This will require you to fill in a brief form with your details, such as your name, age, email address, and contact number.
- ✅ Alternatively, if you know which type of cover you want, click the “Apply Now” button. This will take you to a page with more information about the specific plan you are interested in.
- ✅ On the plan page, you will find details about the cover’s benefits, terms, and conditions. Make sure to read these carefully to ensure that the plan meets your needs and budget.
- ✅ Once you have reviewed the plan details, click the “Apply Now” button to begin the application process. This will require you to provide more detailed information about yourself and any dependents you wish to include on the policy.
- ✅ You must enter your details, including your name, address, and ID number. You must also provide information about your medical history, including any pre-existing conditions or medications you currently take.
- ✅ Once you have filled in all the required information, you will be asked to review and accept the terms and conditions of the policy. Read these carefully to ensure you understand the cover, limitations, and exclusions of the plan.
Finally, you must pay the premium amount to activate your policy. Stratum Benefits offers several payment options, including debit orders, credit cards, and EFT.
Overview of Stratum Benefits Gap cover
Stratum Benefits offers several gap cover plans to supplement medical aid coverage. The plans include Access Optimiser, Base, Compact 300, Corporate Access, Corporate Compact 300, and Access Co-Pay Plus 300. Each plan provides different levels of cover for common medical expense gaps, such as doctors’ and specialists’ private fees, dental expenses, maternity care, radiology, and casualty events.
Additionally, some plans offer benefits such as trauma counseling, accidental death, disability cover, first-time cancer diagnosis cover, and lifestyle benefits like e-learning options for high school students.
The benefits of each plan are subject to an annual overall limit (OAL), which varies depending on the plan. These plans are designed to provide financial protection to policyholders against the cost of medical procedures that their medical aid does not fully cover.
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How to apply for Gap Cover with Stratum Benefits
💙To apply for Gap Cover with Stratum Benefits, you can follow these steps:
- ✅ Visit the Stratum Benefits website at https://stratumbenefits.co.za/.
- ✅ Navigate to the “Gap Cover” section on the website.
- ✅ Select the Gap Cover option that best suits your needs from the available plans – Access Optimiser, Access Co-Pay Plus 300, Base, Compact 300, Corporate Access, and Corporate Access Co-Pay Plus 300.
- ✅ Review the benefits and cover provided by the plan you have chosen.
- ✅ Click on the “Apply Now” button to start the application process.
- ✅ Complete the online application form with your personal information, contact details, and medical aid information.
- ✅ Submit your application online.
Wait for a representative from Stratum Benefits to contact you regarding your application.
How to Submit a Claim with Stratum Benefits
💙To submit a claim with Stratum Benefits, you can follow these steps:
- ✅ Contact Stratum Benefits to confirm your benefits and ensure your policy covers your claim.
- ✅ Download and complete the Stratum Benefits claim form from their website.
- ✅ Gather all the supporting documents required for your specific claim type as listed on the claim form, including medical invoices, statements, receipts, and prescriptions.
- ✅ Complete all sections of the claim form and sign where indicated.
- ✅ Submit you are completed claim form and supporting documents via email to [email protected] or through the Stratum Benefits mobile app or online portal.
- ✅ Ensure that all the information and documents provided are accurate and complete to avoid delays or rejections.
- ✅ Stratum Benefits will acknowledge receipt of your claim within two business days of submission.
- ✅ Your claim will be assessed, and Stratum Benefits may request additional information or documentation if needed.
- ✅ If your claim is approved, Stratum Benefits will pay the benefit amount to you or the service provider directly, depending on your policy terms.
If your claim is rejected, Stratum Benefits will provide the reason for the rejection and any steps you can take to appeal the decision.
How to Submit a Compliment or Complaint with Stratum Benefits
💙Here is a step-by-step process for submitting a compliment or complaint to Stratum Benefits:
- ✅ Contact Stratum Benefits’ customer service department via phone, email, or the online contact form on their website.
- ✅ Clearly state whether you would like to submit a compliment or a complaint.
- ✅ Provide details about the compliment or complaint, including the policyholder’s name, policy number, and the date of the event or incident that prompted the feedback.
- ✅ Stratum Benefits will acknowledge receipt of the compliment or complaint within 24 hours of receiving it.
- ✅ A complaints officer will be appointed to handle the complaint or compliment and will investigate if necessary.
- ✅ The complaints officer will provide a written response to the complainant or the compliment receiver within 10 business days.
- ✅ If the complainant or compliment receiver is unsatisfied with the response, they can escalate the complaint to a senior management team member.
The complainant or compliment receiver can escalate the complaint to the relevant regulatory body if it remains unresolved.
How to Switch My Health Insurance to Stratum Benefits
💙To switch to Stratum Benefits for your health insurance, you must take the following steps:
- ✅ Before switching to Stratum Benefits, you should review your current health insurance policy to determine its benefits, limitations, and exclusions. Understanding what you are getting into and what you will gain or lose by switching is crucial.
- ✅ Research Stratum Benefits to comprehend the available plans and their benefits. This will assist you in selecting the plan that meets your needs and budget.
- ✅ After identifying the plan you want, contact Stratum Benefits for a quote. This can be done via telephone, email, or the Stratum Benefits website.
- ✅ Complete the application form supplied by Stratum Benefits if you are satisfied with the quote. Ensure that you provide accurate information and complete all required fields.
- ✅ Once the application form has been completed, submit it to Stratum Benefits for processing. Depending on your plan, you may be required to provide additional documentation or undergo a medical exam.
- ✅ You can cancel your current health insurance policy after your application has been approved. This will ensure that you are not simultaneously paying for two policies.
Once your previous policy has been canceled, your cover with Stratum Benefits will commence. Be sure to familiarize yourself with your new policy’s terms and conditions and utilize the available benefits.
Stratum Benefits Customer Support
Stratum Benefits provides customer support through various channels to assist policyholders with queries and concerns. These channels include email, phone, and an online contact form on the company’s website. In addition, the support team is available during office hours and strives to respond to inquiries promptly and professionally.
In addition, Stratum Benefits has a comprehensive FAQ section on its website that covers various topics such as product information, claims handling, and policy management. The FAQ section aims to provide policyholders with quick and easy answers to commonly asked questions.
Stratum Benefits also has active social media accounts on popular platforms such as Twitter, Facebook, and LinkedIn for policyholders who prefer to communicate through social media platforms. These accounts serve as additional channels for policyholders to ask questions or raise concerns.
In our personal experience, we found that Stratum Benefits is committed to providing excellent customer support and strives to ensure their policyholders receive the best possible service.
Stratum Benefits vs Notable Competitors – A Comparison
| 🔎 Medical Health Plan | 🥇 Stratum Benefits | 🥈 Clicks Flexicare | 🥉 Dis-Chem Health Insurance |
| 🟥 Years in Operation | 25 years | 56 years | 46 years |
| 🟧 Average # Members | 10,000+ | 1,000+ | 1,000+ |
| 🟨 GCR Rating | None | None | None |
| 🟩 Number of Employees | 500+ | 5,000+ | 18,000+ |
| 🟦 Market Share | 5%> | 20%> | 20%> |
| 🟪 Market Cover | South Africa | South Africa | South Africa |
| 🟥 Customer Rating | 4.1 | 4.2 | 4.4 |
| 🟧 Number of reviews | 870+ | 10+ | 4,000+ |
| 🟨 Mobile App | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟩 Contribution Range (ZAR) | R195 – R656 | R435 – R1064 | R509 – R705 |
| 🟦 International Travel Benefit (ZAR) | n/a | n/a | n/a |
| 🟪 Market Capitalization | n/a | R64.3 billion | R22.34 billion |
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Stratum Benefits Customer Reviews
Highly Professional.
Stratum Benefits is an exemplary company worthy of commendation. Their prompt communication, frequent updates, and highly professional service. They consistently provide a seamless and effortless service of an exceptionally high standard. – Shirley Patton
Prompt Service.
Stratum Benefits responded promptly and fully complied with the provisions of the current contract. As such, there are no grounds for any complaints. – Melanie Putter
Highly Recommended.
I have only received exceptional service and feedback from Stratum since joining the Elite option in 2018. Although there have been some changes since the takeover, any queries I have raised have been handled carefully. Due to their outstanding benefits, I highly recommend Stratum as a gap insurer. – Xander Botha
Stratum Benefits Pros and Cons
| ✅ Pros | ❌ Cons |
| Offers comprehensive health insurance plans with various options to suit different needs and budgets | Waiting periods apply |
| Provides gap cover to help cover out-of-pocket medical expenses | There are only two core plans offered on different levels, namely Primary Care (Individual) and Corporate |
💙POLL: 5 Best Hospital Plans under R200
Our Verdict on Stratum Benefits
According to our analysis of the insurer, Stratum Benefits is a South African health insurance company that offers a range of affordable medical aid products to individuals and businesses. The insurer mainly focuses on providing affordable quality healthcare to its clients.
Stratum Benefits offers various healthcare plans to suit different needs and budgets, including hospital plans, comprehensive plans, and gap cover.
One of the standout features of Stratum Benefits is its commitment to transparency and customer service. The company offers dedicated customer support, and its website provides comprehensive product and service information.
Stratum Benefits also has a user-friendly mobile app that allows customers to access their medical aid information and claims status easily.
Stratum Benefits Frequently Asked Questions
What is Stratum Benefits Health Insurance?
Stratum Benefits Health Insurance is a comprehensive medical health insurance provider that covers certain medical expenses and emergencies.
What are the benefits of Stratum Benefits Health Insurance?
The benefits of Stratum Benefits Health Insurance include hospitalization, chronic medication, day-to-day medical expenses, and emergency medical care.
How do I apply for Stratum Benefits Health Insurance?
You can apply for Stratum Benefits Health Insurance online by contacting their customer service team or joining online from the official website.
What are the requirements for applying for Stratum Benefits Health Insurance?
To apply for Stratum Benefits Health Insurance, you must provide your details, medical history, and payment information.
How much does Stratum Benefits Health Insurance cost?
The premium will depend on the option chosen and how many individuals you register on a single policy. Corporate options are flexible, and Stratum offers tailor-made packages. On the Primary Plus Emergency and Accident Plan option, the cover begins from R195.
What is the waiting period for Stratum Benefits Health Insurance?
The waiting period for Stratum Benefits Health Insurance depends on the type of treatment you require and your medical history. Waiting periods range from three to twelve months.
Does Stratum Benefits Health Insurance cover pre-existing conditions?
Yes, Stratum Benefits Health Insurance covers pre-existing conditions, subject to certain conditions.
Can I change my level of coverage with Stratum Benefits Health Insurance?
Yes, you can change your level of coverage with Stratum Benefits Health Insurance at any time, subject to certain conditions. However, you cannot upgrade or downgrade. You can only switch between the day-to-day and emergency & accident benefit options.
How do you claim from Stratum Benefits Health Insurance?
You claim by submitting your claim form and supporting documents online or via email.
Does Stratum Benefits Health Insurance have a network of healthcare providers?
Yes, Stratum Benefits Health Insurance has a network of healthcare providers. Using a provider within the network could lower out-of-pocket expenses for you.
How do I Downgrade My Plan with Stratum Benefits?
You cannot upgrade or downgrade with Stratum Benefits as the insurer offers a Day-to-Day or an Emergency and Accident benefit option. Neither of these options is ranked higher or lower than the other. Therefore, we recommend speaking to a Stratum Benefits agent for options in switching plans.
How do I add a Beneficiary to Stratum Benefits?
If you want to add a child or adult dependent, you can request the beneficiary addition form by contacting Stratum Benefits by phone, email, or website.
