Personal - FAQ's For Hospital Cash Cover

What is Hospital Cash Cover?
Hospital Cash Cover pays the policy holder a daily amount, selected by yourself, if you are hospitalised. It is designed to help you with the extra financial burden of being hospitalised.
Who is eligible for Hospital Cash Cover?
You are eligible to apply for cover if you are aged 16-65 and a permanent resident of South Africa.
Why do I need cash cover?
Unlike a medical aid where specific procedures and medicines are paid for, the hospital cash cover benefits are paid directly to you. The money can be used for whatever you choose, you could use it to cover the shortfall in medical aid payments or it can be used to cover any shortfall in your income while you are in hospital - the choice is yours.
Do I need a medical examination?
No.
What if I have any pre-existing medical conditions – will I be covered?
  • If you have a medical condition for which you are receiving or expecting to receive a consultation or treatment – this will not be covered.
  • If you have a medical condition for which you have attended or received medical care within the twelve months prior to applying – this will not be covered.
  • Pre-existing medical conditions are covered for optical and dental benefits.
Does the Hospital Cash Cover plan work like a medical aid?
No, the policy is not to be confused with a medical aid. The policy pays a daily benefit if you are admitted to hospital. This daily benefit is constant irrespective of the amount that the hospital charged you.
Are the benefits paid directly to me or to the hospital?
The benefits are always paid to you, the policyholder.
Does the policy pay out if I am admitted to a private hospital?
Yes, the benefits are applicable to any registered hospital in South Africa and the amount paid out does not change if you have been to a government or private hospital.
Does the policy pay out if I am admitted to a government hospital?
Yes, the benefits are applicable to any registered hospital in South Africa.
When does my cover begin?
Most hospital cash cover plans cover your hospitalisation resulting from accidental causes from the Date of Commencement and once the first premium has been paid.  Cover for hospitalisation due to illness commences after either 6 or 12 months (depending on the plan selected by you) of paid premiums.
When can you claim for hospitalisation?
After you have been discharged from hospital you can submit your claims documentation to your cover provider so that the claims department can assess your claim.
What documentation do I need to submit for a claim?
Documentation requirements for claiming differ from provider to provider. Most insurance providers will require you to submit:
  • your final hospital account to establish the dates of admission and discharge
  • a fully completed claim form
  • a medical report form completed by your regular doctor
Be sure to check additional documentation required with your particular provider.

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