African Unity Life underwrites various health insurance benefits. It’s important to note that this is not medical aid, but rather long-term health insurance. We offer this option because most medical aids are too expensive for many employees in the lower- to medium-income segments and we want to ensure that, despite this, they still have access to this essential cover. This is why we offer a solution to make it easy for your workforce to gain access to affordable primary healthcare.
There are various long-term group health cover options available to cover specific needs. Our group health insurance products can be tailored for larger employer groups, brokerages, unions and bargaining councils. We also offer a selection of ready-made options.
Frequently Asked Questions About Health Insurance
What does health insurance cover?
Health insurance provides for hospital cover, day-to-day benefits, and medical costs incurred. A set amount is paid out for each day you are in hospital in the form of a daily cash back.
The hospital cover which our health insurance offers covers several serious illnesses, as well as maternity needs, accidents, ICU care, and also dread diseases. African Unity Life’s health cover also offers cover for issues such as hernias, appendectomies, gall bladder issues, kidney stones, and hysterectomies. This extensive list makes it the best group health insurance for a small business, as you will be able to offer employees health care options which will keep them in good health and stress-free.
As a group health insurance option for your business, African Unity Life is one of the most affordable options. We offer both individual and family plan options for your employees. This means that they can care for their families as well as ensuring that their own health is in good stead.
Health insurance covers chronic illnesses as well, meaning that if you have to take medication for a long period of time or for the rest of your life, this will be covered by your health insurance plan. There are some exclusions that you will find which are common with many health insurance companies.
To find out what is included and what is not, it’s recommended that you see an adviser about whether or not dental services are part of your plan, and whether there are regular General Practitioner visits offered. African Unity Life strives to provide all of their clients with the best possible health plans to meet their needs.
Why do I need health insurance?
Medical aid can be very costly and most low to middle-income employees cannot afford the premiums. Medical insurance is the more affordable option and it helps to cover the costs involved with hospital expenses and day-to-day benefits.
For both large and small business owners, the health of your employees is tantamount to your success, so offering your part and full-time employees a group health plan will keep them in optimal health.
Health insurance allows them to work without having worry about the financial stresses of health issues, and if your company offers health insurance that allows them to add family members, they can care for their family as well.
In the modern world, not having health insurance means that hospitalisation costs will become debilitating. As a business owner, you understand that an employees' mental and physical state directly influences their attitude to and output of work. Nobody plans on becoming sick or being injured, which is why it is so important to have a plan in place in case of any emergencies that might occur.
You will be able to maintain a good standard of health for your employees and in turn, they will be able to maintain a high standard of work. For individuals, having health insurance will ensure that you are able to recover from any health issues without having to pay exorbitant fees.
What waiting periods can be expected?
African Unity Life will determine the relevant waiting period according to a risk assessment done during the application process. These waiting periods are determined according to the claims you might intend on making as well as on any pre-existing conditions you may have.
Waiting periods are put in place to ensure that you do not apply for cover knowing that you will be claiming in the near future, which could be detrimental to both yourself and African Unity Life as an insurer. According to regulations, a three-month general waiting period, and a 12-month pre-existing condition exclusion period can be imposed on applicants.
You will need to speak to our advisers about the waiting periods for your group insurance, but the general waiting period is usually from 30 to 90 days. This is to ensure that your employees will not simply make a claim and then cancel the insurance after being paid.
One of our highly knowledgeable advisers will inform you on whether or not you can waive the waiting period for your employees, but it is in place as protect you as a business owner and the insurance company.
Waiting periods differ from insurer to insurer, so be sure to contact one of the African Unity Life advisers or ask us for a quote, which will include all of the relevant information that you need.
You and your employees will need to be as honest as and upfront as possible so that we can put the correct and fair waiting periods in place.
Will there be any questions with regards to pre-existing conditions when I apply for these benefits?
Yes. During the application stage, we will ask whether you have had any pre-existing conditions in the previous 24 months. There will be a waiting period applicable for these conditions, depending on the benefit plan.
These questions are not asked to make you feel uncomfortable, but to ascertain the state of your health and whether you have any conditions which fall under our exclusion or waiting period list.
African Unity Life strives to provide you with the best possible care and customer experience, and having all of your relevant information will help us to provide a customised plan that suits your particular needs.
A pre-existing condition is considered to be any condition that you have been experiencing symptoms for up to six months prior to applying for health insurance. The condition does not have to be formally diagnosed during these six months and you might not have been aware of it, but it will be classed as one once you have confirmation from a health professional that it is a medical condition.
A medical health professional will be appointed to you when you apply for African Unity Life’s group health insurance and this professional will pose relevant questions based on your records from your regular health practitioner.
Once it has been ascertained whether or not you have a pre-existing condition, a waiting period will be applied to your policy accordingly.
Will the insurer pay my hospital bill directly?
No. In terms of the new Demarcation Regulations, the insurer has to pay the benefit value to the principal member or beneficiary directly. The responsibility will fall to you to use this money to pay for your medical bills or any urgent repayments that you need to make due to being hospitalised.
This is not introduced to increase your financial woes but rather to protect you, as the consumer, and African Unity Life as the insurer. The money that is paid out to the principal member can be used to pay for non-medical expenses, such as paying for your family’s expenses or repaying bills that you were unable to pay while you were in the hospital. African Unity Life prides itself on adhering to the highest standards, and as such, we adhere to this new law without exception.
What is the effect of Demarcation Regulations on my medical insurance?
These regulations came into effect on 1 April 2017 and insurers now have two years to adjust their healthcare product to fall in line with the Demarcation Regulations.
One example of how these regulations will affect your Hospital Cash Plan is if you have been admitted to hospital after being involved in an accident and you have a Hospital Cash Plan with your insurer, and trust that this will cover your medical expenses.
The new Demarcation Regulations make it clear that the insurer cannot conduct the business of a medical scheme, and therefore all hospital cash benefits will be strictly regulated by the Demarcation Regulations in terms of the Long-Term Insurance Act. These regulations stipulate that this cash benefit can only be paid for non-medical expenses.
In essence, what this means is that once you have been admitted to the hospital, the insurer will not be able to pay the hospital directly for all medical expenses. Instead, a daily amount or a lump sum will be paid to the principal member or beneficiary directly. This amount paid will also be limited to R3000 per day (no limitation on the number of days) or if the benefit is being paid as a lump sum, it is limited to R20 000 per annum.
Once the benefit has been paid to the main member or beneficiary, the money may be used for non-medical expenses. Non-medical expenses include paying for childcare while you were in the hospital or for groceries, or other expenses, due to you being in hospital.
The money can also be used by the principal member to pay the hospital accounts. It falls within the principal member or beneficiary’s discretion to decide what is done with the money paid by the insurer.