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UbuntuMed Hospital Plan

Overall, the UbuntuMed Hospital Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and accident cover for its Family Members. The UbuntuMed Hospital Plan starts from R195 ZAR. UbuntuMed has a trust rating of 3.

🔎 Medical Health Plan	🥇 UbuntuMed Hospital
👤 Main Member Contribution	From R192
👥 Adult Dependent Contribution	From R192
🍼 Child Dependent Contribution	From R192
💵 Prescribed Minimum Benefits	None
😷 Screening and Prevention	None
💙 Medical Savings Account	None
👶 Maternity Benefits	None
🏥 Hospital Cover	✅ Yes
📉 Chronic Conditions	None

UbuntuMed Hospital Plan – 6 Key Point Quick Overview

✅ UbuntuMed Hospital Plan Overview
✅ UbuntuMed Hospital Plan Benefits and Cover Comprehensive Breakdown
✅ UbuntuMed Hospital Plan Exclusions and Waiting Periods
✅ UbuntuMed Hospital Plan vs Plans Offered by Other Providers
✅ Our Verdict on the UbuntuMed Hospital Plan
✅ UbuntuMed Hospital Plan Frequently Asked Questions

UbuntuMed Hospital Plan Overview

💙 The UbuntuMed Hospital plan is one of 2, starting from R195. UbuntuMed Hospital plan has no overall annual limit (OAL), unlike similar plans by competitors. It also offers in-patient hospital stabilization, MRI and CT scans, accident cover, physiotherapy, and more.

💙 Gap Cover is not available on the UbuntuMed Hospital Plan. However, UbuntuMed offers 24/7 medical emergency assistance. According to the Trust Index, UbuntuMed has a trust rating of 3.

💙 UbuntuMed Health Insurance has the following two plans to choose from:

✅ UbuntuMed Hospital Plan
✅ UbuntuMed Primary Care Plan

UbuntuMed Hospital Plan Benefits and Cover Comprehensive Breakdown

Health Insurance that the family :

🟥 Overall Limit	There is no overall annual limit.
🟧 In-Patient Hospital	–
🟨 In-Patient Hospital Stabilisation	Only emergencies are covered under this benefit. The actual cost of hospitalization as an in-patient in an emergency requires the patient to be stabilized before being transferred to a public hospital. Surgical procedures are not covered. The maximum amount per incident is R100,000 per person. Pre-approval is required.
🟩 In-Patient Hospital Treatment	Only accidents are covered under this benefit. In the event of injuries sustained in an accident, the actual cost of hospitalization as an in-patient, including all associated services during the hospitalization, at any private facility. Limited to R1,600,000 per person per incident. Pre-approval is required.
🟦 Out-Patient Casualty Treatment	The benefit is payable for injuries sustained in an accident and is limited to treatment in a hospital emergency unit. The maximum amount per incident is R8,000. Pre-approval is required.
🟪 MRI and CT scans	The actual cost of an MRI or CT scan required as a result of an accident-related injury. The annual limit is R21,000 per person. Pre-approval is required.
🟥 Physiotherapy and Occupational Therapy	Physiotherapy and occupational therapy were provided after an in-patient hospitalization due to an accident. Limited to 3 months following discharge from an in-patient hospitalization incident and R4,000 per person per year. Pre-approval is required.
🟧 Accidental Death	The cover is limited to the following: R35,000 maximum per principal insured and first spouse dependent. R10,000 for each child dependent (only in motor vehicle accidents).
🟨 Emergency Evacuation	Emergency Evacuation, including: Ambulance services (air or road). Inter-hospital transfers. Repatriation of mortal remains. Telephonic Medical advice (Ask a Doctor or ask a Nurse). Push to call emergency dialing and find a provider application. Hospital pre-authorisation & guarantee of payment to the treating facility in the event of an emergency/accident.

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UbuntuMed Hospital Plan Exclusions and Waiting Periods

UbuntuMed Hospital Plan Exclusions

💙 The services, conditions, or events listed below are always excluded from coverage.

✅ Nuclear weapons or nuclear material, ionizing radiation, or contamination by radioactivity from any nuclear fuel or nuclear waste resulting from the combustion of nuclear fuel. For this exception, combustion includes any self-sustaining nuclear fission process.
✅ Investigations, treatment, or surgery for obesity or its sequel, or cosmetic surgery, or surgery directly or indirectly caused by, related to, or resulting from cosmetic surgery other than as the result of an Insured Incident.
✅ Suicide, attempted suicide, or self-inflicted injuries unless sustained to save another human life.
✅ Routine physical or any other purely diagnostic procedure, or any other examination in which there are no objective indications of impairment in normal health, and laboratory diagnostic or x-ray examinations, except in the course of a medical condition or disability established by a prior call or attendance of a Medical Practitioner.
✅ The clinical review team of the Underwriting Manager will determine all costs.
✅ Not medically necessary or clinically appropriate, or do not meet the Insured Person’s healthcare needs, inconsistent in type, frequency, and duration of treatment.
✅ Procedures performed in doctors’ offices that are not described in the tariff code list.
✅ Any accident in which the initial accident event occurred before the Insured Person’s policy start date.
✅ The use of any drug or narcotic unless prescribed by and used per the instructions of a registered Medical Practitioner (other than the Insured Person) or any illness caused by the use of alcohol.
✅ Any medical transportation service that is not an emergency.
✅ Addiction to drugs.

UbuntuMed Hospital Plan Waiting Periods

💙 Waiting periods for UbuntuMed’s health insurance policies vary depending on the type of coverage and policy. Here are some typical UbuntuMed wait times:

✅ General medical services typically wait three months, including doctor visits, prescription drugs, and diagnostic tests.
✅ Specialist consultations: A 6-month waiting period is typical for specialist consultations and procedures.
✅ Maternity benefits: There is typically a 12-month waiting period for maternity benefits, which include prenatal care, delivery, and postnatal care.

💙 Finally, a 12-month waiting period is usually required for pre-existing conditions.

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UbuntuMed Hospital Plan vs Plans Offered by Other Providers

🔎 Medical Health Plan	🥇 UbuntuMed Hospital	🥈 Oneplan Health Blue	🥉 EssentialMED Hospital
👤 Main Member Contribution	From R195	R1000	R699.00
👥 Adult Dependent Contribution	From R195	R1,980 for a couple	R699.00 – R751.00
🍼 Child Dependent Contribution	From R195	R1,625 (Single adult + 1 Child) – R2,570 (Couple + 1 child)	R272.50
💵 Prescribed Minimum Benefits	None	✅ Yes	✅ Yes
😷 Screening and Prevention	None	None	✅ Yes
💙 Medical Savings Account	None	None	None
👶 Maternity Benefits	None	✅ Yes	✅ Yes
🏥 Hospital Cover	✅ Yes	✅ Yes	✅ Yes
📉 Chronic Conditions	None	✅ Yes	None

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Our Verdict on the UbuntuMed Hospital Plan

💙 The UbuntuMed Hospital Plan is a health insurance plan that provides emergency and accident-related hospitalization coverage at private hospitals in South Africa.

💙 The plan does not have an overall annual limit. However, it has limited coverage for various services, such as in-patient hospitalization, out-patient casualty treatment, MRI and CT scans, physiotherapy and occupational therapy, and accidental death.

💙 The plan also provides 24-hour medical emergency services through ER24. As a verdict, the UbuntuMed Hospital Plan is a good option for individuals who prioritize cover for unexpected emergencies and accidents but have no comprehensive cover for other medical expenses. However, despite this shortfall in cover, it is a suitable plan for those who require extensive cover for accidents and emergencies and who are otherwise healthy and active.

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UbuntuMed Hospital Plan Frequently Asked Questions

What is the UbuntuMed Hospital Plan?

The UbuntuMed Hospital Plan is a medical insurance plan that covers hospitalization expenses, scans, and rehabilitation.

What does the UbuntuMed Hospital Plan cover?

The UbuntuMed Hospital Plan covers a range of hospitalization expenses relating to emergencies, diagnostics for accidents, and other medical procedures. It also covers some rehabilitation, such as physiotherapy and occupational therapy.

Is the UbuntuMed Hospital Plan an individual or group plan?

The UbuntuMed Hospital Plan can be purchased as an individual or group plan for families.

What is the cost of the UbuntuMed Hospital Plan?

The UbuntuMed Hospital Plan costs R180 per month, much cheaper than most other health insurance providers in South Africa.

Is pre-existing medical cover included in the UbuntuMed Hospital Plan?

There may be some waiting periods that apply for new members who have pre-existing conditions. However, UbuntuMed does not specifically indicate this in the plan’s specifics. Therefore, prospective members must clarify this with the insurer before joining.

What is the process for claiming under the UbuntuMed Hospital Plan?

To file a claim under the UbuntuMed Hospital Plan, you must provide UbuntuMed with documentation of your medical expenses, including bills and receipts. Then, UbuntuMed will review and process the claim according to the plan’s terms.

Adriaan Schoeman

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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