The GP Visits Benefit Explained

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Get Unlimited Doctors Visits

1 Month Waiting Period
Single Benefit Level
Nationwide Network

You get unlimited managed consultations with a network doctor. Your doctor might also prescribe medication, refer you to a specialist, get blood tests and x-rays or perform minor procedures in their rooms.

The Day-to-Day collection of benefits has cover for all of this and more.

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What is Covered?

The GP Visits benefit is all about getting you access to a private network doctor when you need it. It covers:

  • Consultation fee at a network doctor
  • Minor procedures
  • Up to R250 reimbursement for out-of-network doctor visits 3 times a year

The benefit is unlimited which means you may use it as often as is medically necessary. We believe primary care is the gateway to good health so we want you to see a doctor when you need to and avoid letting small concerns turning into serious problems.

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What are Minor Procedures?

These are procedures that a general practitioner may perform in their consulting rooms and includes things like stitches, limb casts, ingrown toenails, clamp circumcision, abscess drainage and nebulisation.

The full list of procedures is not published by the product administrator because it is extensive and is constantly updated as medical procedures change.

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Is Medication Covered?

Yes. Your doctor may prescribe medication. The Medication Benefit is part of the Day-to-Day plan and will cover unlimited formulary medication as well as Over-the-Counter medication.

What is useful to note is that you get dispensing and scripting doctors:

  • Dispensing doctors have got an in-house pharmacy in their consulting rooms which can issue medication directly to you.
  • Scripting doctors do not and will issue you with a prescription that you can take to another pharmacy.
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Are X-Rays and Blood Tests Covered?

Your doctor may need x-rays or blood tests to be taken. These are covered under the Radiology and Pathology benefits which are also part of the Day-to-Day Plan.

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

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Private hospitals across South Africa

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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 GP benefit waiting period?

The waiting period on the GP Benefit is 1 month.

This means that after the first month of your policy's inception, you can use the benefit and visit a network doctor.

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.