Benefits
Episodic Health offers medical insurance benefits, in addition to Day-to-Day cover, that is designed to provide relief for accident and emergency events. Be prepared and get access to private hospitals and healthcare.
Accident Hospitalisation
Stated amounts to cover any costs associated with an accident event that results in hospitalisation.
This means that the amounts available are there to cover any in-hospital costs incurred that are directly related to the accident event, as long as at least 24 hours of hospitalisation was required.
Also, the benefit will still cover any recurring events related to that accident up to the stated amounts chosen for 12 months after the event.
Emergency services are included 24/7 and there is no hospital network applied.
There are 3 levels of cover to choose from
- Level 1
- Singles policies: up to R75,000 per event. R150,000 annual limit.
- Family policies: up to R150,000 per event. R300,000 annual limit
- Level 2
- Singles policies: up to R125,000 per event. R250,000 annual limit.
- Family policies: up to R250,000 per event. R500,000 annual limit
- Level 3
- Singles policies: up to R200,000 per event. R400,000 annual limit.
- Family policies: up to R400,000 per event. R800,000 annual limit
No waiting period, cover is immediately available.
FAQ
Emergency Casualty Visits
Access to after-hours emergency casualty rooms at a hospital
For those emergencies when your network GP is not available, you can access the hospital casualty rooms to get treated. Weekend, after-work, whenever you need it most you still have access to private healthcare.
There is no hospital network but pre-authorisation is required.
3 levels of cover to choose from
- Level 1
- Up to R2,000 per member per year limited to an annual overall limit of R4,000 per policy
- Level 2
- Up to R4,000 per member per year limited to an annual overall limit of R8,000 per policy
- Level 3
- Up to R6,000 per member per year limited to an annual overall limit of R12,000 per policy
1 month waiting period applies
Permanent Disability
Cover for permanent disability as a result of an accident.
The benefit is purely optional. It builds on top of the Accident Hospitalisaiton benefit to provide additional cover for permanent disability and pays out the stated amounts less any medical costs incurred.
There is no hospital network and pre-authorisation is required.
There are 3 levels of cover to choose from
- Level 1
- Up to R200,000 per disability reason for the main member
- Level 2
- Up to R250,000 per disability reason for the main member
- Level 3
- Up to R250,000 per disability reason for the main member and spouse
Cover is immediately available for the main member. 6 month waiting period for the spouse (on level 3)
FAQ
Permanent Disability, for this benefit, means the permanent and total loss of or use of:
- Speech
- Hearing in both ears
- Sight in one or both eyes
- Loss of one or both eyes
- Any limb by physical separation at or above the wrist or ankle
The disability must have been incurred as a result of an accident event.