Your Insurance Benefits:
Unlimited GP consultations with access to over 4 300 network GPs.
This includes minor procedures performed in network GP rooms such as wound stitching or applying a cast to a broken arm.
Out of network GP consultations
You get two visits per annum and you can claim back up to R345 per visit.
Nurse consultations
You get unlimited consultations for minor health concerns with a nurse at a network pharmacy.
Maternity benefit
You get three gynaecologist consultations during your pregnancy and 3 x 2D ultrasound scans per person, per year. This benefit is limited to R4 175 per family, per year. Preauthorization is required.
Specialist consultations
You have access to specialist consultations, when referred by a network GP. Each specialist visit is covered up to R1 675, with a limit of R3 500 per family, per year.
Basic dentistry and optometry
You get access to over 1500 network dentists for basic dental treatment. You get access to 1 eye examination, 1 standard frame and clear spectacle lenses to the value of R599, every 2 years.
Basic pathology and radiology
You get cover for certain pathology tests and x-rays when referred by a network GP.
Acute and chronic medication
You're covered for unlimited acute medication dispensed or prescribed by a network GP during your consultation. You're covered for chronic medication for up to eight chronic conditions including asthma, chronic obstructive pulmonary disorder, diabetes type 1 & 2, epilepsy, HIV/AIDS, hyperlipidaemia, hypertension and tuberculosis.
Waiting periods apply
There is a general two-month waiting period. There is a nine-month waiting period for the maternity benefits. There is a twelve-month waiting period for chronic medication and optometry. There are no waiting periods for the hospital care benefits and the 24/7 telephonic advice.
Health screenings
You have access to health screenings at network pharmacies for blood pressure, cholesterol, glucose levels, body mass index (BMI) and waist circumference, HIV tests and counselling.
Prostate screenings
If you're over the age of 50, you get one prostate-specific antigen (PSA) screening every two years at network pharmacies, subject to availability.
Pap smears
If you're over the age of 21, you get one pap smear every three years.
Vaccination programme
You're covered for the following vaccinations at network pharmacies, subject to availability: Annual flu vaccine - before 31 May, tetanus - once every 10 years, hepatitis A & B - once-off, pneumococcal - once every five years if you are over the age of 60 (pre-authorization is required).
24/7 telephonic advice
You have access to 24 hour unlimited telephonic advice and telephonic or virtual counselling, provided by registered counsellors for trauma counselling and HIV counselling.
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Medical Insurance
Your Insurance Benefits:
- Unlimited GP Consultations with access to over 4 300 network GPs
- Basic dentistry and optometry
- Basic pathology and radiology
- Acute and chronic medication
- Access to emergency hospital care benefits
From Only R672
per month
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