May 18, 2012
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Care Cover
Information about Care Cover
What is Care Cover? | What are the advantages of having Care Cover? | Are there different levels of cover? | Can I add to my cover? | What is the cost of the membership? | How do I claim?
What should you do next?
View our costs, or Find a Healthcare broker, or Browse all products in Insure, or Get online support
What is Care Cover?
You may be under the impression that your medical scheme will pay the full cost of a hospital admission. However, this is not necessarily the case. The majority of specialists, surgeons and anaesthetists charge well above the medical scheme rate. The result is a shortfall between what your medical scheme pays and your medical practitioner charged. You may also have to pay a co-payment or upfront cost. So, who foots the bill? You do, of course. Unless you have an Nhuvuko Care Cover policy to enhance your medical scheme benefits.
What are the advantages of having care cover?
- Can be used to enhance any medical scheme option
- One policy covers the entire family as registered on the medical scheme
- Adult dependants enjoy the same level of cover, at no additional cost
- 3 (three) unique options to ensure the best fit
- Optional Supplementary Oncology Cover for biological cancer drugs
- Underwritten by a well-established insurer - Hollard Insurance
- Fast, efficient and accurate administration
- Emergency Casualty Cover automatically included on all options
- 6 (six) month premium waiver included on all options
Are there different levels of cover?
Yes, you can choose from (3) three different policies depending on the extent of the shortfalls against which you want to insure:
- Care
Covers the shortfalls on authorised in-hospital procedures as a result of the medical practitioner charging more than the medical scheme reimbursement rate.
- Xtra Care
All the benefits of Care plus cover in respect of:- Co-payments on procedures
- Upfront deductibles, and/or
- Sub-limits on procedures
- Xtra Care Ultimate
All the benefits of Xtra Care plus:- A maternity booster of R2 500
- R5 000 Emergency Casualty Cover
Can I add to my cover?
Yes you can enhance your cover by adding the Oncology Supplementary Benefit which will cover the shortfalls on chemotherapy or radiotherapy, including biological cancer drugs, as a result of limits or co-payments imposed by your medical scheme.
For more information on waiting periods and exclusions please feel free to download the brochure
What is the cost of the membership?
The oldest life insured dictates the applicable premium (younger or older than 60).
| Policy | Price per month | ||
|---|---|---|---|
| Care (younger than 60) |
R97 per policy | ||
| Care (60 and older) |
R120 per policy* | ||
| Xtra Care (younger than 60) |
R120 per policy | ||
| Xtra Care (60 and older) |
R144 per policy* | ||
| Xtra Care Ultimate (younger than 60) |
R136 per policy | ||
| Oncology Supplementary Benefit (younger than 60) |
R70 per policy | ||
| *Please note that these options do not include the Emergency Casualty Cover and premium waiver benefit | |||
How do I claim?
This policy does not form part of your medical aid so you have to submit a separate claim.
You must submit your claim form with ALL the necessary documents (hospital account and relevant provider accounts, as well as a medical aid statement) after the procedure but within 6 (six) months from first date of service. Claims received after 6 (six) months will be rejected.
Claim forms are available from the Nhluvuko Customer Care Centre on: 0860 100 296
Payment will be made within 7 (seven) to 14 working days after all required documents have been received.
