Day-to-Day Medical Cover

Access private doctors, dentists, medication and more on a nationwide network from only R446 pm

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Flexible Cover for Your Everyday Medical Expenses

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What Health Plan are you going to build?

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

Premiums

Build a Plan on Your Budget

Episodic Day-to-Day Health Insurance plans are flexible, your final premium depends on the number of family members and your choice of benefit levels.

Members

Decide how many of your family members will be covered. You can add your spouse and up to 6 children on one policy.

1

Cover

Choose Day-to-Day plan and/or Hospital plan.

Hospital plan has flexible benefit choices. Add what you want and leave out what you don't need.

2

Levels

Some benefits have a choice of up to 3 Levels of Cover. Each Level has different cover limits.

3

Network

A Network You Can Depend On

Access private healthcare when you need to see a doctor, visit a dentist, get medication or go to hospital.

Nationwide Network
Private Hospitals & Doctors
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Claims

Simple & Efficient Claims

Find out how the claims process works for rapid and pain-free claims handling.

Claims paid directly to providers
Works with private hospitals
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Comprehensive

Add Hospital Cover

Build a more comprehensive plan when you add hospital benefits to your Day-to-Day cover. Access private hospitals for accidents, casualty and illnesses or planned procedures.

Health Insurance for hospital expenses
Flexible benefit choices
Nationwide Network
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Medical Aid

Boost Your Medical Aid Cover

You can use your Day-to-Day benefits with a Medical Aid to boost your out-of-hospital cover. Adding insurance cover gives you a more comprehensive solution without having to rely only on the limited Medical Savings Account (MSA).

Add insurance cover for primary health benefits
Build a more comprehensive total solution
Works with any Medical Aid
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FAQ

You have Questions, We have Answers

Find answers to the most common questions about Day-to-Day cover below. You can also browse our Help pages and Blog posts for more information.

Are there age limits for health insurance?

All new members joining an EssentialMED policy must be younger than 65 years (on the data of inception of the policy).

Child dependants must be unmarried and younger than 21 years. However, if your child is still a registered full-time student, then this age limit is increased to 26 years.

How many people can be on one policy?

Essential Med Health Plan policies from Episodic can include

  • you
  • your spouse/partner
  • up to 6 children

That makes a total of up to 8 people per policy. To include more people, you can simply take out a second policy.

Where can I find the network doctors?

The Network page has all the information you need to find a provider on the EssentialMED network. There is an online search tool available to look up providers in your region.

What are the waiting periods?

Health Insurance, unlike Medical Aid, has no general Waiting Period. Each benefit has it's own waiting period.

Waiting periods can range from

  • Immediate cover for accident events
  • 1-3 months for frequently used low-risk benefits like doctors and medication
  • 6-12 months for benefits that are not used that often or that have a higher risk factor like Critical Illnesses.

Pre-existing medical conditions may result in endorsements on the policy that add a 12-24 month waiting period for that claims related to that specific condition.

What does an "unlimited" benefit mean?

When a health insurance benefit is "unlimited" it means that the benefit can be used as many times as you need without any specific annual limits.

The only conditions are that the claim or consultation is medically necessary and fits within the defined formulary or protocols.

Unlimited benefits are usually managed. This means that pre-authorisation may be needed after a certain number of times that the benefit is used. This helps to ensure that it is you utilising the benefit and that you are getting the proper care that you deserve. You can find more details on the Network page.

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Reviews

See What People Are Saying About Us

Episodic is a top-rated Financial Services Provider with 4.8 stars on Trustpilot and 4.9 stars on Google Reviews. Thanks for sharing the love!
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I am looking forward to be part of this Medical Insurance, it seems that they have thought about everything to ensure their members get the best value for money.
Antoinette H.
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I can definitely say the initial service and telephone consultation was brilliant. Bradford is a wonderful broker and I felt like I received all the information I required and am very happy with the plan and the rates.
Charlene A.
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This was the easiest application ever. Friendly, helping, caring. Thank you Gabby and her team for all the assistance and support. I am proud to be a member. Thank you.
Jolandi G.
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For not giving up i rate Muneeb 5 stars. I many times could not talk, and didn't take his calls. Then he will email me and ask if I understand the health insurance benefits and policies. And I found him another applicant. I think its a good product for this price. Thank you. We have started our journey with you.
Cecilia G.
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I'm very impressed with the type of service I received from Elize [...] she was very much on top of things all the time and her response time was amazing thanks so much.....
Tyrone S.
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Wonderful service. Very quick to respond/assist. Love it
Caroline S.
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Once again, Episodic health has exceeded expectations! The efficient, professional manner in which they attend and complete enquiries are to be commended. Within less than 24 hours the enquiry was resolved and you have another happy client! Well done to Elize and Teswin for your efficient service.
Andrea B.
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Quick and easy application and very helpful consultant. So far so good!
Ashlea J.
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John [...] can articulate well and explain until you understand. You even forget you speaking to a sales person, great great service.
Karen S.
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I'm happy with all services the prices are affordable and I'm happy with everything discussed. Thanks Bradford [...]
Lecritia R.
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I would like to send a huge thanks to Michael [...] for his time, patience and excellent service. Even when I was still trying to decide on which medical insurance company to go with, by far his service stood out from the rest. He explained every detail to me and assured me that if I needed any help, he is just an email away. Thank you Michael.
Michaela S.
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Amazing service from Elize [...]. Prompt replies and went out of her way to assist me with my situation. Thanks for making this process seamless.
Nanette A.

PARTNERS

We Work With the Best

Episodic uses the best service providers in South Africa to deliver our products and services to you. You are in good hands.
EssentialMEDAULGenricSpecSaversExecuspecsPAMCDRCPPNMediscorAfrica Assist
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