Enjoy a Rich Set of Primary Health Benefits from R420 pm
Day-to-Day benefits cover your basic everyday medical needs for out-of-hospital expenses. Choose your own level of cover and control your budget.
See a doctor as often as you need to
- Unlimited managed consultations
- In-room procedures
- Limited out-of-network cover
Keep your winning smile
- Consultations & basic procedures
- Upgrade for root canals, crowns & dentures
- Choose from 3 Levels of cover
Medication when you need it
- Unlimited medication
- Extensive formulary
- Limited Over-the-Counter medication
Medication for chronic conditions
- Unlimited formulary medication
- 24 specified chronic conditions
- Unlimited basic blood tests
- Extensive protocol covers most common pathology tests
Get X-Ray vision
- Unlimited benefit
- B&W, single or double sided X-rays
- Limited prenatal growth sonar scans
Specialists when you need them
- Up to R2,000 per policy per year
- Choose from 3 Levels of Cover
- No network
See more for less
- Eye tests
- Frames & lenses
- Choose from 3 levels of cover
Planning a family
- Prenatal scans
- Prenatal vitamins
- GP visits & specialists
- Blood tests
What Health Plan are you going to build?
Get a quote and find out. Talk to us or build your own.
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.
Decide how many of your family members will be covered. You can add your spouse and up to 6 children on one policy.
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.
Some benefits have a choice of up to 3 Levels of Cover. Each Level has different cover limits.
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.
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.
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).
You have Questions, We have Answers
Are there age limits for health insurance?
All new members joining a 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?
Episodic health insurance policies can include
- 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 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. We do this 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.
See What People Are Saying About Us