Accident & Hospital Medical Cover

Access private hospitals for accidents, illnesses & maternity from only R186 pm. Choose your own benefits & save on your premiums.


Flexible Cover for Your Hospital Expenses



Your Choice of Hospital Benefits from R186 pm

Hospital benefits on the Essential Med Health Plan have flexible benefit choices for accident and hospital events. Build the hospital cover you need and control your budget. Follow the steps below to see how.

Step 1

All Hospital Plans start with a base set of Accident and Casualty benefits. These are required on all hospital plans.

Step 2

You can choose to add hospital cover for illnesses and planned procedures (that are not related to an accident)

Step 3

You can upgrade your Illness Hospitalisation cover with extra benefits that offer additional amounts for maternity or more serious events. Each of these benefits is optional.

Step 4

Lastly, you can add on disability cover to any hospital plan combination you have chosen

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 Health Insurance Hospital Plans are flexible, your final premium depends on the number of family members and your choice of benefits.


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.

Nationwide Network
Private Hospitals & Doctors
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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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Add Day-to-Day Cover

Build a more comprehensive plan when you add primary health benefits to your hospital cover. Access private doctors, dentists, medication and more from only R446 pm.

Everyday out-of-hospital benefits
Nationwide Network
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Medical Aid

Alternative to a Medical Aid

A Health Insurance Hospital Plan is an affordable alternative when you can't afford a Medical Aid. Get covered for hospital expenses with stated amounts for defined events.

Stated amounts to cover hospital expenses
Lower premiums
Governed by the Long Term Insurance Act
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You have Questions, We have Answers

Find answers to the most common questions about Hospital 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 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.

Which hospitals can I use?

The Essential Med Health Plan has no hospital network. Theywork with all major hospital groups and day clinics.

This is because health insurance issues a Guarantee of Payment based off your stated benefit limits so it doesn't need specific contracts with hospitals. Medical Aids, on the other hand, negotiate tariff rates with providers.

You can read more about how this works in our helpful blog article. The Network page also has more information on the networks and how to find providers.

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.

How are claims paid?

When you need to go to hospital, the insurer will issue a Guarantee of Payment to the provider based on the event and your available limits on the specific benefit. This happens at the pre-authorisation stage.

Claims will generally be paid directly to the provider. See the Claims page for more detail.

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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.


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.
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