Universal Healthcare Health Insurance
Overall, Universal Healthcare is a trustworthy and comprehensive health insurance provider that offers 24/7 medical emergency assistance and competitive monthly premiums for employer groups. Universal Healthcare Health Insurance Plans are available to employees who earn less than R40,000 per month. Universal Healthcare has a trust score of 2.4.
Universal Healthcare Health Insurance has the following four plans to choose from:
1. Universal Healthcare Essential Advance Plan
2. Universal Healthcare Essential Plan
3. Universal Healthcare Standard Advance Plan
4. Universal Healthcare Standard Plan
| 👤 The average number of members | 5,000+ |
| 1️⃣ Number of Markets | 1 |
| 👥 Number of Employees | 500+ |
| 🔟 Average Customer Rating | 2.4 |
| 💯 Average Number of Reviews | 100+ |
| 📈 Market Share | <1% |
| 4️⃣ The number of plans offered | 4 |
| 📌 Number of Hospitals in Network | 100+ |
| 📱 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 | 15 – 26 conditions, depending on the plan |
| 🍼 Maternity Benefit | ✅ Yes |
| 💷 Monthly Premium Range (ZAR) | Variable, member-to-member basis |
| ⚠️ Average Waiting Period | 3 – 12 months |
Universal Healthcare – Analysis of Insurers’ Main Features
- ✅ Universal Healthcare Plan Overview
- ✅ Universal Healthcare – Advantages Over Competitors
- ✅ Overview of Universal Healthcare Gap cover
- ✅ How to apply for Health Insurance with Universal Healthcare
- ✅ How to apply for Gap Cover with Universal Healthcare
- ✅ How to Submit a Compliment or Complaint with Universal Healthcare
- ✅ How to Switch My Health Insurance to Universal Healthcare
- ✅ Universal Healthcare Customer Support
- ✅ Universal Healthcare vs Notable Competitors – A Comparison
- ✅ Universal Healthcare Customer Reviews
- ✅ Universal Healthcare Pros and Cons
- ✅ Our Verdict on Universal Healthcare
- ✅ Universal Healthcare Frequently Asked Questions
Universal Healthcare Plan Overview
Four tiers of coverage are available to businesses through the Universal Healthcare Plans: Standard, Standard Advance, Essential, and Essential Advance.
Furthermore, the level of protection each choice provides varies, with the Advance choices including more Emergency Benefits.
Members have access to several benefits regardless of the plan option selected. These include basic emergency dental care, basic emergency optometry services, basic X-rays, basic blood tests, and visits to a general practitioner to treat acute and chronic conditions.
Those who select the Advance upgrades will gain access to exclusive bonuses. In addition, hospitalization cover due to sudden illness or injury is included through the Hospital Casualty/Emergency Room benefit.
Transportation by road to the nearest and most appropriate healthcare facility within South Africa’s borders is also included in the plan as part of the Emergency Medical Response service.
Each member is free to select the healthcare plan that best meets their individual needs under the umbrella of the Universal Healthcare Plans.
Those who need the most comprehensive cover possible can consider the Advance options, which include additional emergency benefits. In addition, members have several options for meeting their basic healthcare requirements, regardless of the plan they select.
Discover more about Health and Medical Insurance for South Africans
Health Insurance Universal Healthcare – Advantages Over Competitors
Being a Member of Universal Healthcare includes the following advantages:
- ✅ The policies offered by Universal Healthcare cover preventive care, inpatient stays, outpatient procedures, and pharmaceuticals.
- ✅ Low-Cost Insurance Premiums Individuals and families can save money by switching to Universal Healthcare because its premiums are typically lower than those of private health insurance plans.
- ✅ Individuals with chronic illnesses can get the care they need without fear of being denied coverage because of their condition, thanks to the no-exclusions policy of Universal Healthcare.
- ✅ With Universal Healthcare, people do not have to worry about exhausting their benefits before getting the care they need because there are no annual or lifetime caps on their cover.
- ✅ Regardless of age, wealth, or health, everyone has access to quality medical care under a system of Universal Healthcare. This ensures that people of varying socioeconomic backgrounds have equal access to the same standard of medical care.
- ✅ Universal Healthcare can save on overhead without needing insurance companies to spend money on advertising, underwriting, and claims processing.
- ✅ Promoting public health, Universal Healthcare can lessen the strain on healthcare systems by facilitating early detection and treatment of disease outbreaks.
- ✅ Healthcare providers can increase their bargaining power under Universal Healthcare systems by negotiating with a single-payer instead of numerous insurance companies. The price of healthcare and pharmaceuticals may be lowered as a result.
- ✅ When people no longer need to rely on their employers to provide their healthcare, it can free them up to pursue their business ventures. Innovation and new employment opportunities may increase as a result.
Finally – With Universal Healthcare, no one has to worry about being turned down for coverage or going bankrupt because of medical bills; everyone can rest assured that they will receive the care they require.
Read more about 5 Best Medical Aid for people not working in South Africa
Overview of Universal Healthcare Gap cover
Health Insurance Cover that is affordable :
Universal Healthcare, a South African insurance provider, offers two different gap insurance plans, Universal Health Gap and Gap Plus. Both items aim to close the financial chasm between what people receive from health insurance and what it costs to get sick or injured.
Cover for medical scheme members’ out-of-pocket expenses not covered by their medical scheme is available through the Universal Health Gap product. Co-pays, deductibles, and other out-of-pocket costs for healthcare that are not covered by insurance fall into this category. In-hospital care is covered up to 500% of the medical scheme rate, and out-of-hospital care is covered up to three times the rate.
Benefits for accidental death and disability, a one-time payment upon learning of a cancer diagnosis, and a cash payment upon completing a hospital stay are also part of the Universal Health Gap package.
The Universal Health Gap Plus product provides the same cover as the original Universal Health Gap but at increased maximums. It pays up to five times the medical scheme rate for care received outside of a hospital and up to eight times the rate for care received inside a hospital. The product also provides increased maximums for the cash benefit upon hospitalization, lump sum payment upon cancer diagnosis, and accidental death and disability benefits.
Pre-existing conditions may not be covered in either product, and both have waiting periods and exclusions. Furthermore, the Universal Healthcare gap cover is not intended to replace medical scheme membership but to supplement it.
Discover the 10 Best Gap Covers in South Africa
How to apply for Health Insurance with Universal Healthcare
The only way to get health insurance through Universal Healthcare is when you are employed by a business in South Africa that applies for group health insurance through the insurer. Once an Employer applies and is approved, employees are all added to the same option.
How to apply for Gap Cover with Universal Healthcare
To apply for Universal Healthcare’s Gap Cover, follow these steps:
- ✅ Peruse the Gap Cover and Gap Plus Cover brochures on the Universal Health website to determine which option aligns with your requirements.
- ✅ After choosing a plan, complete the online application form, or download it and fill it out before submitting it to Universal Health via email or fax.
- ✅ While applying, furnish personal and medical details, including medical aid particulars and pre-existing medical conditions.
- ✅ Universal Health will review your application and inform you of its acceptance status. In addition, you will receive a policy document stating your cover and relevant terms and conditions upon approval.
After obtaining your policy document, you can access the benefits of your Gap Cover or Gap Plus Cover. If you need to make a claim, follow the claim process provided in your policy document and contact Universal Health’s customer service team for support.
How to Submit a Claim with Universal Healthcare
To claim from Universal Healthcare, you can follow these easy steps:
- ✅ Ensure you have a valid Universal Healthcare policy covering the treatment or service you request reimbursement for.
- ✅ Compile all relevant documentation pertaining to the treatment or service you received, including medical bills, receipts, and reports.
- ✅ Visit the website for Universal Healthcare and download the claims form corresponding to your policy. You may also request a claims form from their customer service department.
- ✅ Fill out the claim form with accurate and comprehensive information, including your personal information, policy number, and treatment or service details.
- ✅ Include all required supporting documentation with the claim form.
- ✅ Email, fax, or mail the claim form and supporting documents to Universal Healthcare. Follow the directions regarding where and how to submit your claim.
- ✅ Until Universal Healthcare processes your claim, you must wait. Then, they will evaluate your claim and, if necessary, request additional information or documentation.
Upon approval of your claim, Universal Healthcare will reimburse you for covered expenses per your policy’s terms and conditions.
How to Submit a Compliment or Complaint with Universal Healthcare
To submit a compliment or complaint with Universal Healthcare Medical Insurance, take the following steps:
- ✅ Contact the customer service number or email the customer support team at Universal Healthcare Medical Insurance with your compliment or complaint.
- ✅ Provide specific information about your compliment or complaint, such as the date and time of the incident, the names of any employees involved, and the applicable policy or plan numbers.
- ✅ Indicate how you want Universal Healthcare Medical Insurance to respond to your compliment or complaint.
- ✅ Supply Universal Healthcare Medical Insurance with your contact information, such as your phone number or email address, so they can contact you.
Follow up with Universal Healthcare Medical Insurance if you do not receive a response within a reasonable time to ensure that your compliment or complaint is addressed.
How to Switch My Health Insurance to Universal Healthcare
You cannot freely switch your health insurance to Universal Healthcare. Universal Healthcare offers health insurance to Employer Groups in South Africa and all employees must be on the same option.
Therefore, the only way to switch to Universal Healthcare is if your employer uses their services and all employees are transferred to the insurer.
READ: Things to consider before switching your medical aid
Universal Healthcare Customer Support
Universal Healthcare provides customer service to assist clients with inquiries, claims, and policy modifications. Here is what you should know about their customer service:
- ✅ Universal Healthcare’s customer service team can be reached through various channels. For example, you can call their customer service number, email them, or use their online contact form to submit a question.
- ✅ The customer support team at Universal Healthcare can assist you with various issues, including policy changes, claim submissions, plan selection, billing inquiries, and other general inquiries.
- ✅ Depending on your location and the availability of language support, Universal Healthcare’s customer service team can assist you in multiple languages.
- ✅ Universal Healthcare provides its clients with various online resources, such as a FAQ section, a learning center, and dedicated support.
Universal Healthcare values client feedback and encourages clients to provide feedback or file a complaint via their customer support channels. They take all feedback seriously and strive to resolve any problems promptly.
Universal Healthcare vs Notable Competitors – A Comparison
| 🔎 Medical Health Plan | 🥇 Universal Healthcare | 🥈 Dis-Chem Medical Insurance | 🥉 Day1 Health |
| 🟥 Years in Operation | 15 years | 45 years | 20 years |
| 🟧 Average # Members | 5,000+ | 1,000+ | 5,000+ |
| 🟨 GCR Rating | None | None | None |
| 🟩 Number of Employees | 500+ | 18,000+ | 150+ |
| 🟦 Market Share | <1% | 20%> | <1% |
| 🟪 Market Cover | South Africa | South Africa | South Africa |
| 🟥 Customer Rating | 2.4 | 4.4 | 3.1 |
| 🟧 Number of reviews | 100+ | 4,000+ | 130+ |
| 🟨 Mobile App | ✅ Yes | ✅ Yes | ❎ No |
| 🟩 Contribution Range (ZAR) | Variable | R206 – R763 | R325 – R935 |
POLL : 5 Best Hospital Plans under R1500 in South Africa
Universal Healthcare Customer Reviews
Exceptional.
The service provided by Universal Health Insurance was exceptional, and the agent was very helpful in promptly providing me with all the information I required. – Phindile Ndlovu
Very helpful.
Over the last week, Universal Health Insurance has been very helpful in providing the pre-authorizations that I required. I communicated through the Universal Healthcare app, and the experience was smooth and efficient. – Ryan du Plessis
Great Support.
I would like to thank the Universal Health Insurance agent who showed genuine care and assisted me during a difficult time. Her kind words and advice were extremely helpful, and I received excellent service. – Cecilia Taylor
Universal Healthcare Pros and Cons
| ✅ Pros | ❎ Cons |
| Comprehensive cover for medical services | Annual limits on some services, such as physiotherapy and occupational therapy |
| Affordable premiums based on a member-to-member basis, offering customized options according to every budget | No cover for some specialized treatments, such as oncology and infertility treatments |
| No exclusions for pre-existing conditions | Longer wait times for some elective procedures |
| Promotes public health | Limited choice of doctors and hospitals |
| Increased bargaining power for healthcare providers | Bureaucratic Procedures for accessing care |
| Encourages entrepreneurship | The plan is not revolving and must be renewed every 12 months |
Our Verdict on Universal Healthcare
Our comprehensive review shows that Universal Healthcare (South Africa) offers a comprehensive health insurance plan that provides cover for a wide range of medical services for employer groups. The plan offers several advantages, including affordable premiums, no exclusions for pre-existing conditions, and no lifetime or annual coverage limits.
Universal Healthcare is accessible to everyone, regardless of income, age, or health status. This promotes public health by providing access to preventive care and early treatment. Additionally, the plan can increase the bargaining power of healthcare providers and encourage entrepreneurship. However, the plan does have some limitations. For example, while it provides cover for various medical services, we found annual limits on some services, such as physiotherapy and occupational therapy.
Furthermore, the plan does not cover some specialized treatments, such as oncology and infertility treatments. However, despite these drawbacks, Universal Healthcare provides a solid health insurance option for employer groups in South Africa.
Regardless, we urge prospective health insurance members to carefully review the policy details and limitations before joining, especially if they require coverage for specialized treatments.
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Universal Healthcare Frequently Asked Questions
What is Universal Healthcare?
Universal Healthcare is a health insurance provider in South Africa that offers medical coverage to individuals and families.
What plans does Universal Healthcare offer?
Universal Healthcare offers various medical aid plans, including Standard, Standard Advance, Essential, and Essential Advance, to meet the diverse needs of its clients.
How can I enroll in Universal Healthcare?
To enroll in Universal Healthcare, visit their website, select a plan that meets your needs, and fill out an online application form.
How long does it take to get approval for my Universal Healthcare plan?
The approval time for Universal Healthcare plans varies. However, it usually takes a few days to receive confirmation of your policy.
Does Universal Healthcare offer dental coverage?
Yes, Universal Healthcare offers dental coverage in their plans.
Can I add my spouse and children to my Universal Healthcare policy?
Yes, you can add your spouse and children to your Universal Healthcare policy by selecting a family plan.
What is the waiting period for pre-existing medical conditions with Universal Healthcare?
A three-month general waiting period or a 12-month condition-specific waiting period can be imposed on a policy, depending on when members join the plan.
Can I change my Universal Healthcare plan?
Yes, you can change your Universal Healthcare plan anytime by contacting their customer service team and selecting a new plan that meets your requirements.
What is the policy duration for Universal Healthcare, and do I need to renew it annually?
The policy duration for Universal Healthcare is typically 12 months from the start date of your policy. At the end of the policy duration, you must renew your policy to continue receiving medical coverage.
How do I Downgrade My Plan with Universal Healthcare?
Members of Universal Healthcare cannot freely downgrade their plans. Universal Healthcare offers group health insurance to Employer groups in South Africa. Therefore, all employees of a group must join and remain on the same plan.
How do I add a Beneficiary to Universal Healthcare?
To add a dependent to Universal Healthcare, you must communicate with your employer. Universal Healthcare offers insurance to Employer Groups. Therefore, members cannot freely add or remove dependents.
