2024 HEALTH INSURANCE
ENHANCEMENTS & CHANGES

• NETWORK GP CONSULTATIONS
  • Pre-authorisation no longer required for 10 or more consultations but for each consultation per person per year
  • Add the GP Pre-Auth Waiver for an additional monthly premium per person to see your GP without prior approval
  • Read more about this process change and the waiver benefit in the following section
• OUT-OF-NETWORK GP CONSULTATIONS
  Increases from R 300 to R 310 per consultation, limited to 2 consultations per person per year
• TELEMEDICINE, INTERCARE ONLINE GP CONSULTATIONS and NURSE CONSULTATIONS
  No longer require pre-authorisation
• SPECIALIST CONSULTATIONS
  Increases from R 1 420 to R 1 500 per consultation and R 3 000 to R 3 150 per family per year
• PRE-BIRTH CONSULTATIONS
  Increases from R 3 600 to R 3 800 per family per year, limited to 2 consultations and 2 ultrasound scans
• DENTAL CARE
  Increases from R 1 350 to R 1 375 per consultation and R 4 000 to R 4 100 per family per year

If you’re covered by the Essential Primary Plus or Corporate Essential Day-to-Day Benefit Option, the below process change must be noted.

NETWORK GP CONSULTATIONS

For 2023, the 10^th combined consultation and every consultation after that with either your network or out-of-network GP, a telemedicine GP consultation, an online Intercare GP consultation or a nurse consultation requires pre-authorisation. Effective 1 January 2024, each network GP consultation requires pre-authorisation unless you have the GP PRE-AUTH WAIVER.

This waiver benefit, at an additional premium of R 39 per person per month for members covered by the Essential Primary Plus Day-to-Day Benefit Option, allows you to see your network GP without prior approval. The monthly premium for members covered by the Corporate Essential Day-to-Day Benefit Option is subject to a quote.

If you want to add the waiver benefit to your existing Day-to-Day Benefit Option, please get in touch with your financial advisor or our Client Support Centre for more information.

We must receive your request by 31 January 2024.

e yoursupport@stratumbenefits.co.za

If you don’t add the waiver benefit by this date, you can do so for the new benefit year beginning 1 January 2025.

• EMERGENCY COVER
  Increases from R 27 800 to R 30 000 per person per event
• ACCIDENT COVER
  Increases from R 1 300 000 to R 1 500 000 per person per event
• CASUALTY ACCIDENT COVER
  Increases from R 7 195 to R 7 600 per person per event
• MRI AND CT SCANS
  Increases from R 18 900 to R 20 000 per person per year
• PHYSIO AND OCCUPATIONAL THERAPY
  Increases from R 3 600 to R 3 800 per person per year

This is for you if you’re covered by the Essential Primary Plus or Corporate Essential Emergency & Accident Benefit Option. 

HOSPITAL CASH PLAN

This brand-new option will be available starting 1 January 2024.

For an additional premium per person per month, you get a DAILY HOSPITAL PAYOUT BENEFIT that pays out when you’re hospitalised due to an accident and a CHILDBIRTH PAYOUT BENEFIT that pays out if you’re hospitalised for childbirth.

The monthly premium for members covered by the Corporate Essential Emergency & Accident Benefit Option is subject to a quote.

If you want to apply for the cash plan, please get in touch with your financial advisor or our Client Support Centre for more information.

We must receive your request by 31 January 2024.

If you don’t apply for this option by this date, you can do so for the new benefit year beginning 1 January 2025.

e yoursupport@stratumbenefits.co.za

DAILY HOSPITAL PAYOUT BENEFIT

Pays a benefit amount of R 2 000 per person per day, limited to R 30 000 per event, for each full day spent in the hospital with a minimum stay of 2 days (48 hours) when hospitalised due to an accident.

This benefit isn’t subject to any waiting periods.

CHILDBIRTH PAYOUT BENEFIT

Pays a benefit amount of R 20 000 per birth when the newborn or children reach 14 days of age.

This benefit is subject to a 12-month waiting period.

In the event of childbirth, only the Childbirth Benefit is payable, not both payout benefits.