Day-to-Day Medical Cover from R397 pm

Get access to private doctors, dentists, medication and more on a nationwide network. Choose your own cover and save on your premiums.

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Your Everyday Out-of-Hospital Expenses Covered

Day-to-Day cover is a collection of primary health insurance benefits that gives you access to quality medical care for your basic everyday needs. Flexible levels of cover allow you to control your budget and save on your premium.

You can take it on its own or combine it with Hospital Cover or a Medical Aid hospital plan.

GP Visits

See a doctor as often as you need to

  • Unlimited managed doctor visits
  • Covers consultations & minor procedures
  • Limited out-of-network consultations
  • 1 month waiting period
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Dentistry

Dentistry

Keep your winning smile with the Dentistry Benefit

  • Unlimited dentist visits
  • Covers consultations & basic procedures
  • Root canals, crowns & dentures
  • 3 levels of cover to choose from
  • 6 month waiting period
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Acute Medication

Extensive medication cover

  • Unlimited medication
  • Extensive formulary
  • Limited Over-the-Counter (OTC) medication
  • 1 month waiting period
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Chronic Medication

Medication for chronic conditions

  • Unlimited medication
  • Covers 24 specified chronic conditions
  • 6 month waiting period
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Pathology

Pathology

See what is happening in your blood with the Pathology Benefit

  • Unlimited basic blood tests
  • Covers the most common pathology tests
  • 1 month waiting period
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Radiology

The Radiology Benefit that gives you X-Ray vision

  • Unlimited black & white, single or double sided X-Rays
  • 2x ultrasound scans during pregnancy
  • 1 month waiting period
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Specialists

Annual amounts for specialist consultations

  • Up to R2,000 per year
  • 3 levels of cover to choose from
  • Extensive list of specialists supported
  • 3 month waiting period
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Optometry

Optometry

See more for less with the Optometry Benefit

  • 3 levels of cover to choose from
  • Free eye tests
  • Spectacles & contact lenses
  • 12 month waiting period

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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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 of Doctors & Dentists
Private hospitals across South Africa
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How the Premium Works

When you build a plan, your premium depends on the number of family members on the plan and your choice of benefits with their level of cover

1
Members

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

2
Plan

Select Day-to-Day plan, Hospital plan or both for a combined plan.

3
Benefits

Hospital cover also offers flexible benefit choices. Add what you want and leave out what you don't need.

4
Levels

Most benefits have a choice of up to 3 levels of cover. Each level has different cover limits.

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Simple & Efficient Claims

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

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No upfront payments
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Claims paid directly to providers

Ready to build a plan?

Getting a quote is quick and easy. We are here to help you every step of the way.
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Key Features

Out-of-Hospital

Day-to-Day Benefits cover events that do not require hospital admission. Our Hospital Cover is designed for in-hospital expenses.

Claims

Claims are paid directly to the providers and settled within defined service levels.

Networks

Some Day-to-Day benefits use a nationwide network. Other benefits can be used with any provider.

Compatible

Day-to-Day benefits work with a Medical Aid. They can be used with your existing hospital plan to boost your out-of-hospital cover.

Waiting Periods

Each benefit has it's own waiting period. Frequently used benefits have shorter waiting periods.

Flexible

You have a choice of the level of cover for the Dentistry, Optometry and Specialist benefits. This affects your final premium.

Affordable

Episodic's unique flexibility of benefit choices gives you greater control over your budget.

No Lock-in

You are not locked in to your policy choice for the year. Make amendments when you need to as your budgets and needs change.

Age Limit

Underwriting rules require that all new members joining a policy be younger than 65 years.

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What People are Saying About Us

4.9 /5 star rating based on independent reviews on Google

reviewer
Antoinette H.
5 stars
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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.
reviewer
Carmen C.
5 stars
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... friendly, quick and made me feel right at home as always. Would 100% recommend Episodic wherever I go : )
reviewer
Busisiwe N.
5 stars
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I can proudly say this one of the best Health Cover thus far as I have had a wonderful experience with one of your best Sales Agents
reviewer
Nanette A.
5 stars
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... Prompt replies and went out of her way to assist me with my situation. Thanks for making this process seamless.
reviewer
I Miller
5 stars
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... always available to assist and very quick to respond - thank you for your great service. Better than any other Medical Insurance companies that we have dealt with
reviewer
Charlene A.
5 stars
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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.
reviewer
Rohayne S. J.
5 stars
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I just really want to thank Michael ... He is very helpful and is patience. Hope the company see the efforts he put in.☻
reviewer
Celeste H
5 stars
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... She gave me the best customer service and went out of her way to give me information and reassurance . She called me back twice with more info and advice and if that was not enough she e-mailed me more information. She really cared about my situation. She really went the extra mile and i felt like she put her self in my shoes ...
reviewer
Jolandi G
5 stars
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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.
reviewer
Siyabonga N
5 stars
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I am happy with the level of professionalism Faranaaz displayed whilst assisting me with my query..
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Maternity Cover on the Day-to-Day Plan

The Maternity Benefit on our Hospital Cover is designed to help cover the birth of your child in hospital. Day-to-Day cover also has a collection of benefits that you can use during your pregnancy.

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One ultrasound scan for 1st & 2nd trimesters each at a network GP or radiology practice
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Formulary medicine on the Medication Benefit
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See a Obstetrician or Gynecologist on the Specialist Benefit
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Blood tests on the Pathology Benefit
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Answers to Your Questions

What does "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.

Unlimited benefits are usually managed. This means that pre-authorisation is needed after a certain number of times that the benefit is used 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.

What is the waiting period?

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.

Where I can find the network doctors?

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

How are claims paid?

Claims are paid directly to the medical providers. You can find all the details on our claims page.

What are the age limits?

All new members joining a policy must be younger than 65 years on the date of inception of the policy.

Child dependants must be unmarried and younger than 21 years before they will need to start their own policy.

However, if your child is still a registered full-time student, then they may stay on the policy as a child dependant until they turn 26.

How many people can be on a policy?

Episodic health insurance policies can include:

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

To include more people, you can simply take out a second policy.