The ICU Benefit Explained

Extra cover for Intensive Care Units


Extra Cover for Intensive Care Unit Expenses

Upgrade your Illness Hospitalisation benefit with additional cover specifically for Intensive Care Units.

The Illness benefit does pay for hospital expenses but ICU costs are usually a lot more expensive. The ICU benefit offers up to R106,000 extra for up to 5 days in an ICU.

The benefit is optional but it does require you to include the Illness Hospitalisation benefit on your Hospital Plan.

3 Month Waiting Period
2 Benefit Level Choices
Optional Benefit
Requires Illness Hospitalisation

Choose Your Level of Cover

Flexible levels of cover mean you get to build your plan to suit your needs and budget.

Level 1

R13,250 per day

Up to R66,250 available per event

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Level 2

R21,200 per day

Up to R106,000 available per event

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How Does It Work?

Find answers to the most common questions about this benefit. Browse our Help pages and Blog posts for more information.

What is covered?

The benefit adds extra cover for up to 5 days in an Intensive Care Unit while admitted to hospital for an illness. You can see it as a kind of upgrade for the Illness Hospitalisation Benefit.

The amounts covered are per day in an ICU. They are not in addition to the Illness Hospitalisation benefit, either one or the other applies but if you are in an ICU then the ICU benefit will apply.

How do Admission Days work?

There is up to R106,000 available to pay for ICU costs but it is broken up into specific amounts available per day that you spend in ICU (up to a maximum of 5 days).

Each admission day is calculated as 24 consecutive hours spent in ICU and each admission day follows on from the previous day.

For example, if you spend 72 hours in ICU then, with Level 2, you would have available:

  • R21,200 for the first day
  • R21,200 for the second day
  • R21,200 for the 3rd day
  • adding up to R63,600 for the 3 days

What is the waiting period?

There is a 3 month waiting period before any new member on a policy can claim on this benefit.

Is authorisation required?

Yes. In general, all hospital related claims need to be authorised first.

Authorisation is a simple procedure where the administrator and the hospital determine:

  • if the procedure you need is covered by your policy
  • if you have available amounts left over after previous claims

The authorisation procedure is described on the Claims page.

What Health Plan are you going to build?

Get a quote and find out. Talk to us or build your own.


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