HealthCare CashBack Plan
Always have a back-up plan. Our healthcare plan gives you a cash payout to cover everyday expenses while you are in hospital.
HealthCare CashBack Plan
Always have a back-up plan. Our healthcare plan gives you a cash payout to cover everyday expenses while you are in hospital.
OVERVIEW
You get better, we'll cover your bills
An unexpected hospital stay can turn your world upside down. As one of South Africa’s most trusted insurance companies, we'll help you set it straight with our Metropolitan HealthCare CashBack Plan. It isn't a medical aid; it's a plan that pays a pre-defined cash amount to cover expenses not related to the cost of medical treatment.
Cover starts from as little as R12 per day.
Get up to R3 000 for every day you spend in hospital.
Cover yourself and your immediate family.
Get 12.5% of your premiums back as a loyalty benefit for paying your premiums on time and keeping your plan active.
A no-claim bonus of 10 times your daily benefit amount if you do not claim.
Your HealthCare CashBack plan can help you pay for things that your medical aid does not cover. You can use the payout to:
Pay a babysitter to look after your children while you’re in hospital.
Pay for travel costs to visit the hospitalised family member.
Pay for meals at home.
Or cover loss of income while in hospital.
INCLUDED & ADD-ON BENEFITS
Healthcare Cashback cover benefits
Let's take a closer look at the benefits that come with your Metropolitan HealthCare Cashback Plan.
Daily cash
Metropolitan will pay a Daily Cash benefit to help with expenses when an insured life is in the hospital.
CashBack benefit
Get cash back for paying your premiums and keeping your policy active, plus a no-claim bonus after three years without a claim.
Payment Protection
After you, the plan owner, turns 85, no further premiums will be payable, and all insured lives will continue to be covered.
Payment Protection on plan owner death
Add the Payment Protection on Death benefit and no more premiums will be due if you, the policy owner dies before you turn 65.
Intensive Care Unit benefit
If an insured life is admitted to ICU, double the daily benefit will be paid for each full day spent there.
Value Protection benefit
Cover the rising cost of living (inflation). Add the Value Protection benefit to your plan to keep up with rising costs.
Claim in 2 easy steps
Making a Metropolitan HealthCare CashBack claim is an easy process.
Frequently asked questions
Your HealthCare CashBack Plan questions answered
When can I claim?
You can claim benefits under this plan no matter what the reason for your hospitalisation is, as long as the claim meets the requirements and conditions of your healthcare plan and is not an excluded condition or during a waiting period.Claims must be submitted within 6 months after the insured life is discharged from the hospital. If you miss this deadline, your claim will not be paid.
Metropolitan will request the necessary documents to process the claim.
If there is an inquest to get further details, you must submit the required documents within three months of the inquest's conclusion.
What is a Daily Cash benefit?
You may receive the pre-defined daily benefit amount when an insured life has been in hospital for at least 2 full days (48 hours). A full day is defined as a continuous 24-hour period from the time of admission.
If an insured life is admitted to the Intensive Care Unit (ICU), double the daily benefit amount will be paid for each full day spent there, up to a maximum of R3 000 per day.
How many days may I claim for?
The maximum number of full days that you may claim is limited to 60 days a year per insured life.
The first year begins on your plan start date and the limit resets on the plan anniversary. Claims under this policy will be limited to a maximum of R200 000 per year.
Who will get my claim payout?
This benefit is payable to you, the policy owner. Metropolitan will not pay your health service provider.
What is the CashBack benefit?
There are two kinds of CashBack benefits that you may receive:
- a Loyalty CashBack benefit
Your Loyalty Benefit will pay out even if there have been Daily Cash benefit claims. Metropolitan will pay a percentage of your premiums back to you after 24 months, provided that your plan did not lapse during this 24-month period. Thereafter, Metropolitan will pay a percentage of your premiums back to you every 36 months, provided that your plan did not lapse during this 36-month period.
- a No-Claim Bonus
The No-Claim Bonus rewards you when you have not made any Daily Cash claims within a fixed three-year period. The payment is guaranteed, provided:
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- You have not cancelled the policy.
- All premiums are paid up to date.
- No claims have been made for the Daily Cash Benefit for any of the lives covered during the 3-year period.
Is there a waiting period before I can claim?
A waiting period is a period of time when an insured life is not insured for some or all events. Waiting periods apply to each insured life even though premiums are paid. The waiting period starts from the policy entry date. Condition-specific waiting periods of up to twelve months may be applied to the policy. The lives and conditions applied are noted in your plan summary.
A 3-month waiting period applies to each insured life from the entry date when that life was added. The benefit will not pay out if an insured life is hospitalised due to natural causes during the waiting period. If an insured life is hospitalised due to an accident, the benefit may be paid out.
