Accident & Hospital Cover from R165 pm

Episodic's hospital plan lets you choose your own cover and save on your premiums. Get access to private hospitals for accidents, illnesses, maternity and more.

Hospital
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The Ultimate in Flexible Benefit Choices

Choose the benefits you need at the level of cover you want to build a hospital plan that is unique to you and your budget. You can take it on its own or combine it with Day-to-Day Cover for a comprehensive plan.

Ambulance - hybrid

Accident Hospitalisation

Hospital cover for accidents

  • Up to R800,000 per year with R15,000 emergency room cover
  • Choice of 3 levels of cover
  • No waiting period
  • 24/7 Emergency Services
  • Required benefit
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Casualty - hybrid

Emergency Casualty

Visit a hospital casualty ward in emergencies

  • For casualty visits not related to accidents
  • Up to R12,000 cover per year
  • Choice of 3 levels of cover
  • 1 month waiting period
  • Required benefit
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Illness Hospitalisation

Hospital cover for illnesses & planned procedures

  • Covers amounts per day in hospital
  • Up to R48,500 cover per event
  • 3 levels of cover to choose from
  • 3 month waiting period
  • Optional benefit
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ICU - hybrid

Intensive Caure Unit

Extra cover for Intensive Care Units

  • Covers amounts per day for ICU treatment
  • Up to R100,000 cover per event
  • 2 levels of cover to choose from
  • 3 month waiting period
  • Optional benefit. Requires Illness Hospitalisation.
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Dread Disease - hybrid

Dread Disease

Extra cover for Critical Illnesses

  • Covers 8 most common critical illnesses
  • Up to R350,000 cover per member
  • 3 levels of cover to choose from
  • 12 month waiting period
  • Optional benefit. Requires Illness Hospitalisation.
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Maternity - hybrid

Maternity

Private hospital cover for the birth of your child

  • Up to R30,000 cover for natural birth or C-Section
  • 12 month waiting period
  • Optional benefit. Requires Illness Hospitalisation.
  • See Day-to-Day cover for other maternity benefits
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HI Permanent Disability - hybrid

Permanent Disability

Permanent Disability cover for accidents

  • Up to R250,000 cover
  • Specified accident related disabilities
  • No waiting period
  • Optional benefit.

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.

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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Simple & Efficient Claims

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

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No upfront payments
paid
Claims paid directly to providers
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Key Features

In Hospital

Hospital benefits require hospital admission for at least 24 consecutive hours. Day procedures are not covered under these benefits.

Claims

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

Networks

Day-to-Day benefits use a nationwide network. Hospital benefits can be used with any major private hospital.

Waiting Periods

Each benefit has it's own waiting period. Frequently used benefits have shorter waiting periods. Accidents have no waiting periods.

Flexible

You have a choice of benefits and their level of cover. 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.

Compatibility

Hospital cover can't be used with a Medical Aid at the same time since they cover the same things.

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What People are Saying About Us

4.9 /5 star rating based on independent reviews on Google

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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.
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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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Answers to Your Questions

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.

Are there network hospitals?

Episodic health insurance has no hospital network. We work with all major hospital groups.

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.

The Network page has all the information needed.

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.