Health4Me Silver

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Health4Me Silver

A well-rounded health insurance at a competitive price

Health4Me Silver is a balanced health insurance option that brings you high-quality and competitively priced private healthcare when you need it. 

This is a mid-level option that allows you the flexibility to structure your cover based on the benefits you really need.

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    Day-to-day benefits

    GP visits

    Unlimited Network GP visits per member per year

    Network GP visits can either be face-to-face or video call (virtual) consultations

    Hello Doctor pre authorisation is not required

    GP in room procedures

    Minor medical procedures performed as part of a Network GP consult in rooms, such as stitching of wounds and nebulisation

    Hello Doctor

    Hello Doctor consultations are unlimited and can either be chat, phone call or video call (virtual) consultations

    Specialist visits

    A maximum of 2 visits, limited to R1 150 per visit and up to R2 300 per member/family per year is applied.

    Members may consult any specialist, subject to a Network GP referral and pre-authorisation.

    Shortfalls will be payable by the member.

    A 3 month waiting period applies

    Acute medication

    Provided in accordance with the Momentum CareCross Network prescribed acute medication formulary. Rules and protocols apply.

    Basic pathology

    Unlimited when members visit their Momentum CareCross Network GP, and are referred by their Network GP, according to the Health4Me pathology list.

    Basic radiology

    Unlimited cover for black and white x-rays, when linked to a Network GP visit and referred by a Network GP, according to the applicable Health4Me radiology list

    Basic and emergency dentistry

    Covered at any dentist on the Dental Network

    Basic dentistry such as fillings, extractions, infection control, cleaning and polishing of teeth

    Specialised dentistry such as bridges, crowns, surgical extractions, implants, root canals, gold fillings, dentures and braces are not covered

    Provided in accordance with the Dental Network protocols and approved Health4Me dentistry list

    A 3 month waiting period applies

    Basic optometry

    Covered at any optometrist on the Optometry Network

    Benefit available every 2 years

    1 Eye test and 1 pair of clear standard single vision lenses, or 1 pair of bi-focal lenses, with a standard frame Sunglasses, tinted lenses, hard coating and contact lenses are not covered

    A 3 month waiting period applies

    Maternity benefit

    1 Foetal growth 2D scan per member per pregnancy

    Antenatal pathology tests linked to a Network GP visit and referred by a Network GP, according to the applicable Health4Me pathology list

    Antenatal vitamins provided in accordance with the Network prescribed acute medication formulary, rules and protocols are applied

    Pre-authorisation is required

    Flu vaccination

    1 Flu vaccination per member per year at any pharmacy clinic, preferably a Dis-Chem, Clicks, MediRite or Pick n Pay pharmacy clinic.

    Health assessment

    1 Health assessment (blood pressure test, cholesterol and blood sugar finger prick tests, height, weight and waist circumference) per member per year at a pharmacy clinic, preferably a Dis-Chem, Clicks, MediRite or Pick n Pay pharmacy clinic.

    EAP telephonic services

    Counselling and support services for adults, teenagers and children.
    Trauma and critical incidence counselling.
    Legal assist, credit health and debt management services.
    Managerial support services.

    Road accident claims

    Advice for road accident claims (via EAP services).

    Workman’s compensation claims

    Advice for injury on duty claims (via EAP services).

    Multiply Starter

    Multiply Starter is free and offers rewards from a range of partners.
    Members get great discounts and cashbacks on big brands like Edcon (CNA, Edgars and Jet), Dis-Chem and more.

    Additional Value Added Services included in Policy

    This benefit incentivises members with monthly airtime, based on their Healthy Heart Score.
    Participating members will receive the following benefits:

    Activation airtime
    Up to 500MB of data or R50 airtime.
    Upon registration, you will receive R50 airtime.

    Monthly airtime
    Based on your Healthy Heart Score, you will receive monthly airtime as follows:
    Up to 1GB of data or R80 airtime with a Green Healthy Heart Score.
    Up to 500MB of data or R50 airtime with an Amber Healthy Heart Score.
    Up to 250MB of data or R25 airtime with a Red Healthy Heart Score.

    *This benefit is only available to the main member, and not to spouses or children covered under the policy.

    Members can qualify for tax rebates for qualifying medical expenses and claim these expenses on their annual tax returns.

    Bloom’s Meditax product includes completing a full breakdown of the taxpayer’s qualifying additional medical expenses to assist customers with claiming these amounts back from SARS in your annual income tax return.

    Also included is the cost of submitting your tax return.

    For this benefit to be available, you will need to be up to date on your monthly fees for the year of assessment.

    A nominal amount will be debited to cover the cost of submitting your return if your paid fees do not cover the full assessment period.

    Premiums

    Main Member

    from R521 / per month

    Spouse

    from R521 / per month

    Child

    from R298 / per month

    Major medical event benefits

    Major medical event benefits are added onto the Health4Me day-to-day benefits options, and include cover for accidents and emergencies to ensure that you and your loved ones receive high quality care when you really need it. Accident and emergency cover provides in-hospital benefits for qualifying accidents and emergencies at a private hospital. A hospital cash and maternity lump-sum benefit, as well as a funeral benefit are also included to ensure that you are covered holistically.

    Take a look at our other health insurance options

    Partner with Health4Me for top-quality healthcare at an affordable price.

    From entry-level to comprehensive day-to-day benefit cover, as well as a variety of major medical event benefit cover, we have a solution that suits your needs.

    Bronze

    from R 485 / per month
    • Our entry-level option is designed to cover day-to-day needs and includes unlimited GP visits, acute medication, maternity benefits and more.
    Most Popular

    Gold

    from R 563 / per month
    • Our most comprehensive option covers all the benefits offered on the Bronze and Silver options, plus specialist
      visits.

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