Overall, the Universal Healthcare Essential Advance Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and affordable premiums to Members. Universal HealthcareΒ Health Insurance Plans are available to employees who earn less than R20,000 per month. Universal Healthcare has a trust score of 2.4.
π Medical Health Plan | π₯ Universal Healthcare Essential Advance |
π International Cover | None |
π€ Main Member Contribution | Variable |
π₯ Adult Dependent Contribution | Variable |
πΆ Child Dependent Contribution | Variable |
π Gap Cover | β Yes |
π Annual Limit | β Yes |
π· Screening and Prevention | None |
πΆ Medical Savings Account | None |
πΌ Maternity Benefits | β Yes |
π The Universal Healthcare Essential Advance Plan is one of 4. The Essential Advance has competitive and affordable premiums. It covers chronic conditions, maternity, dentistry, radiology, accidental injuries, emergency medical illness, and more.
π Gap Cover is available on Universal Healthcare Essential Advance Plan, along with 24/7 medical emergency assistance. According to the Trust Index, Universal Healthcare has a trust rating of 2.7.
ππΎ 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
π The Universal Health & Accident Plan offered by Universal Healthcare is based on the principle of cross-subsidization. This means that all policyholders pay the same contribution rate, regardless of age or health status, and anyone may join the plan at any time.
π To ensure that policyholders are covered as they age or become ill, they are encouraged to contribute to the plan when they are young and healthy.
π Depending on when they join the plan, a three-month general waiting period or a 12-month condition-specific waiting period may be imposed on their policy. Depending on the selected option, premiums for the Universal Health & Accident Plan are calculated on a per-person, per-month basis.
π The employer or the employee can pay the full premiums associated with the selected plan option and the number of covered lives. The employer pays for the premiums in advance.
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π₯ General Practitioners (GPs) | Unlimited cover for GP visits if they are part of the Universal Healthcare Provider Network. Includes acute medication. Includes small in-room procedures such as wound care. |
π§ Chronic Medication | The benefit covers 26 conditions. Chronic condition registration is required. Chronic medication must be obtained from a UHPN dispensing doctor or pharmacy. Stated Benefits are paid monthly per registered condition per insured person. |
π¨ Basic Radiology | Specified X-rays, as requested as part of a General Practitioner event. Member must use a radiologist on the Universal Healthcare Provider Network. For X-rays, a Stated Benefit amount is payable. |
π© Basic Pathology | Specified Pathology, as requested as part of a General Practitioner event. Members must use a radiologist on the Universal Healthcare Provider Network. For Pathology, a Stated Benefit amount is payable. |
π¦ Optometry | Limited to one eye test event and one pair of specified single or bifocal lenses and frames at a Universal Healthcare Provider Network optometrist. Limited to one exam and glasses per insured person every 24 months. |
πͺ Dentistry | A stated benefit amount is dedicated to emergency dental procedures. Must use a dentist that is part of the Universal Healthcare Provider Network. Covered once per insured person every 12 months. |
π₯ Maternity | A stated benefit amount is payable for 2 ultrasound scans during pregnancy. The ultrasound must be performed or requested by a Universal Network General practitioner. The benefit includes certain pathology tests per insured female per twelve months. |
1οΈβ£ Emergency Accidental Injuries Hospital Casualty/Emergency Room Benefit Hospitalization because of an Accidental Emergency Injury | Hospital casualty/ER benefit or Hospitalisation for Accidental Emergency Injury is limited to R100,000 per insured person per 12-month period. Pre-authorized treatment will pay severity-based amounts up to the benefit limit. Accident-related hospitalization is covered only if clinically necessary. |
2οΈβ£ Emergency Medical Illness Hospital Casualty/Emergency Room Benefit Hospitalization because of an Emergency Medical Illness | Includes hospital casualty/ER benefit or emergency medical illness hospitalization. Limited to R25,000 per insured per year. Pre-authorized treatment will pay severity-based amounts up to the benefit limit. This benefit only covers emergency medical illnesses and does not cover hospital casualty/ER doctor consultations. Only emergency medical illness stabilization requires hospitalization. |
3οΈβ£ Emergency Medical Services Response to an accident scene or medical emergency and transportation (via road) to the nearest private or public hospital within South Africa | Limited to R25,000 annually. |
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π The Essential from Universal Healthcare offers comprehensive healthcare coverage. However, some exclusions are common in South African health insurance policies. Among these exclusions are the following:
π Typically, experimental treatments or procedures that have not been proven effective are excluded from the Essential Advance Plan.
π Universal Healthcareβs Essential offers a range of benefits and coverage options.Β However, like other health insurance policies in South Africa, the plan has waiting periods for certain services. The waiting periods for the Universal Healthcare Essential Advance Plan are typical for health insurance policies in South Africa, and they include the following:
π It is important to note that the waiting periods for the Universal Healthcare Essential Advance Plan may vary depending on the specific plan and cover options selected by the policyholder.Β Therefore, we urge prospective members to review the terms and conditions of the policy to understand the coverage and waiting periods before enrolling.
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π Medical Health Plan | π₯ Universal Healthcare Essential Advance | π₯ Oneplan Health Professional | π₯ KeyHealth Origin |
π International Cover | None | None | β Yes |
π€ Main Member Contribution | Variable | R1,465 | R2,451 |
π₯ Adult Dependent Contribution | Variable | R2,795 for a couple | R1,746 |
πΆ Child Dependent Contribution | Variable | R2,340 (Single adult + 1 Child) β R3,415(Couple + 1 child) | R799 |
π Gap Cover | β Yes | None | β Yes |
π Annual Limit | β Yes | β Yes | None |
π· Screening and Prevention | None | None | β Yes |
πΆ Medical Savings Account | None | None | None |
πΌ Maternity Benefits | β Yes | β Yes | β Yes |
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π Universal Healthcareβs Essential Advance Plan offers numerous benefits, including unrestricted physician visits, radiology and pathology services, and access to a network of private hospitals and healthcare professionals. In addition, this plan covers long-term medication costs and provides members with free annual health examinations.
π Our unbiased review reveals that the Essential Advance Plan provides an extensive array of benefits tailored to the healthcare requirements of most people, resulting in a remarkable value.
π You might like to learn more about:
The Universal Healthcare Essential Advance Plan is a health insurance policy offered by a South African insurance company that provides comprehensive health coverage, including hospitalization, chronic medication, and day-to-day benefits, at an affordable price.
The benefits of the Universal Healthcare Essential Advance Plan include unlimited private hospitalization cover, chronic medication coverage, maternity benefits, and day-to-day benefits such as GP consultations, specialist consultations, acute medication, and emergency medical services.
The cost of the Universal Healthcare Essential Advance Plan depends on several factors. Therefore, it is determined according to a member-to-member basis. However, the plan is designed to be affordable. As a result, it offers excellent value for money compared to other health insurance policies in South Africa.
Yes, you can choose any healthcare provider registered with the South African Medical Association or the Health Professions Council of South Africa.
Yes, the Universal Healthcare Essential Advance Plan covers pre-existing conditions after a waiting period of 12 months.
You must submit a claim form and supporting documents to claim with the Universal Healthcare Essential Advance Plan. You can submit the claim form and documents online or by visiting one of the companyβs branches.
No, the Universal Healthcare Essential Advance Plan has no waiting period for hospitalization benefits.
No, you cannot customize your policy with Universal Healthcare because your employer takes out health insurance on behalf of their employees, and all employees must be on the same option. As a result, all employees have access to the same benefits, with no room for customization.
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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