How to cope with dental anxiety
Nov 29, 2023
Health4Me Gold
The premium health insurance option for comprehensive cover
Health4Me Gold is our premium yet affordable health insurance option.
Health4Me benefits include day-to-day benefits, value-added services like the More4Me monthly airtime stipend, MediTax tax rebates, and major medical events benefits. This option provides the most comprehensive benefits and you are granted the flexibility to structure your own benefits based on your individualised health needs.
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.
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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
Unlimited GP consultations with a Hello Doctor GP
Hello Doctor consultations can either be via chat, phone call or video (virtual) call
Hello Doctor consultations include scripting of formulary-based medication, in accordance with the Network prescribed acute medication formulary, rules and protocols are applied
Hello Doctor consultations include referral for pathology, according to the applicable Health4Me pathology list
Hello Doctor consultations include referral for radiology, according to the applicable Health4Me radiology list
Specialist visits
A maximum of 2 visits, limited to R1 220 per visit and up to R2 440 per member/family per year is applied Members may consult any specialist, subject to a Network GP referral and pre-authorisation
The specialist may refer the member for pathology and radiology according to the applicable Health4Me pathology and radiology lists
Shortfalls will be payable by the member
Waiting periods apply
Acute medication
Provided in accordance with the Network prescribed acute medication formulary
Rules and protocols are applied
Chronic medication
Provided in accordance with the Network prescribed chronic medication formulary
Rules and protocols are applied
27 Chronic conditions are covered as follows:
Addison’s Disease, Asthma, Bipolar Mood Disorder, Bronchiectasis, Cardiac Dysrhythmias, Cardiac Failure, Cardiomyopathy, Chronic Obstructive Pulmonary Disease, Chronic Renal Disease, Coronary Artery Disease, Crohn’s Disease, Diabetes Insipidus, Diabetes Mellitus Type 1, Diabetes Mellitus Type 2, Epilepsy, Glaucoma, Haemophilia, HIV, Hyperlipidaemia, Hypertension, Hypothyroidism, Multiple Sclerosis, Parkinson’s Disease, Rheumatoid Arthritis, Schizophrenia, Systemic Lupus Erythematosus and Ulcerative Colitis
Chronic medication is provided in accordance with the Network prescribed chronic medication formulary
Pathology and radiology related to condition monitoring is provided according to the applicable Health4Me pathology and radiology lists
Pre-authorisation is required
Waiting periods apply
Basic pathology
Unlimited cover for pathology, when linked to a Hello Doctor or Network GP visit and referred by a Hello Doctor or Network GP, according to the applicable Health4Me pathology list
Basic radiology
Unlimited cover for black and white x-rays, when linked to a Hello Doctor or Network GP visit and referred by a Hello Doctor or 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
Waiting periods apply
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
Provided in accordance with the Optical Network protocols and approved Health4Me optometry list
A 3 month waiting period applies
HIV benefit
Post-exposure prophylaxis (PEP) medication is provided in accordance with the Network prescribed HIV medication formulary, to prevent HIV infection in the event of accidental exposure to blood or fluids from an infected person, or by any other means
Antiretroviral medication is provided in accordance with the Network prescribed HIV medication formulary
Pathology related to condition monitoring is provided according to the applicable Health4Me pathology list
Pre-authorisation is required
Waiting periods apply
Maternity benefit
2 Foetal growth 2D scans 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 in accordance with the Network prescribed acute medication formulary, rules and protocols are applied
Antenatal support (access to current and credible information on all topics related to parenthood) via BabyYumYum
Support post-partum from a nurse/midwife at home with bathing, swaddling, latching and feeding Nurse/midwife home visits on day 2 and week 2 after the birth of the baby
Pre-authorisation is required
Flu vaccination
1 Flu vaccination per member per year at any pharmacy clinic, preferably at 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 screening) is provided per member per year at a pharmacy clinic, preferably at 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 Engage
Multiply Engage is free and offers rewards from a range of partners
Members get great discounts on big brands like Makro, Nando’s, Intercape and FlySafair, as well as on the Multiply online shop
Additional Value Added Services included in Policy
More4Me incentivises members with monthly airtime, data, Shoprite and Checkers vouchers or Takealot vouchers, based on their Healthy Heart Score
Participating members will receive the following benefits:
Activation airtime
Activation reward: Up to 500MB data/R50 airtime, R50 Shoprite and Checkers voucher or R50 Takealot voucher
Monthly airtime
Based on their Healthy Heart Score, members will receive monthly rewards for a period of 12 months, until their next health assessment is due
Green: Up to 1GB data/R80 airtime, R80 Shoprite and Checkers voucher or R80 Takealot voucher
Amber: Up to 500MB data/R50 airtime, R50 Shoprite and Checkers voucher or R50 Takealot voucher
Red: Up to 250MB data/R25 airtime, R25 Shoprite and Checkers voucher or R25 Takealot voucher
Members can save up their rewards and redeem even larger
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 R658 / per month
Spouse
from R658 / per month
Child
from R387/ 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
570
/
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.
Silver
from R
610
/
per month
- Our balanced option covers the essentials as well as additional benefits such as maternity benefits, dentistry, optometry and more.
