The GP Visits Benefit Explained
See a network doctor as often as you need to
Unlimited Managed Doctors Visits
Get the benefit that lets you and your family see a network doctor as often as you need to. You get unlimited managed consultations as well as basic in-room procedures.
General Practitioners (GPs) are the backbone of Primary Healthcare. A network GP can prescribe medication, get blood tests, refer for x-rays or refer you to a specialist... all of which have cover on the Day-to-Day Plan.
If you are away or on holiday, you get up to 3 out-of-network consultations per year reimbursed up to R250 each.
How Does It Work?
Find answers to the most common questions about this benefit. Browse our Help pages and Blog posts for more information.
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
What are minor procedures?
These are procedures that a doctor may perform in their consulting rooms and includes all the usual 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.
What is the waiting period?
There is a 1 month waiting period before any new member on a policy can claim under this benefit.
What does "unlimited" benefit mean?
An "unlimited" benefit means that it can be used as many times as you need without any specific annual limits on usage. The only conditions are that the claim is medically necessary.
Unlimited does not mean "uncapped". Some benefits still have limits on how much is covered.
What does "managed" benefit mean?
Unlimited benefits are usually "managed". This means that pre-authorisation is needed after a certain number of times that the benefit is used. This is done for security to ensure that it is you utilising the benefit and that you are getting the proper care that you deserve.
For the GP benefit you may be required to get authorisation from the
- 5th consecutive consultation for individual policies
- 12th consecutive visit for family policies
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