Medical Insurance
The day-to-day benefits of Medical Insurance give you access to private healthcare. Medical Insurance is cheaper than you think. Medical Insurance gives South Africans access to private healthcare at an affordable price.
You can get a free quote now from Get Medical Insurance.
Medical Insurance provides coverage for various day-to-day medical expenses.
We pay for GP visits in our Service Provider Network, at 100% of the agreed rate. This includes minor medical procedures, as performed in your Doctor’s rooms. This GP visit coverage is subject to a list of approved codes.
Connect with a Doctor without leaving your home. We pay 100% of the agreed rate for My Telehealth Virtual Consultations.
You can visit a nurse that's part of our Service Provider Network. Your nurse visit cover includes visits for the treatment of minor illnesses, including:
Two health screening assessments at a Network Pharmacy Clinic including:
This benefit provides access to Acute Medication covered at 100% of the agreed rate. This applies provided:
You can get your Over the Counter (OTC) Medication from a Network Pharmacy covered at 100% of the agreed rate. Ask your pharmacist for advice on Over The Counter (OTC) Medication.
Chronic Medication is covered if:
The Prescribed Medication forms part of the Chronic Medication formulary.
You have registered for the Chronic Medication with the Contracted Services Provider.
After approval of the Chronic Medication, you can obtain your Chronic Medication at a Network Provider, contracted pharmacy or contracted courier pharmacy who will deliver your Chronic Medication to the address you selected at no additional cost.
One flu vaccination for qualifying insured parties per annum.
Cover for your HIV programme, including cover for:
One consultation with a Network Dentist for a full mouth examination. One preventative treatment that includes cleaning, scaling and polishing. Fluoride Treatment is also covered for children under the age of 12 years.
Additional consultations when required for:
Oral radiography in accordance with Network protocols and approved codes. Pre-authorisation is required for certain benefits and Treatment Guidelines apply.
Emergency root canal for pain and sepsis only. Pre-authorisation is required.
One eye test per insured party per annum at a Network Optometrist. No pre-authorisation is required.
One pair of glasses (one standard frame and one pair of single or bi-focal lenses) every 24-months. Pre-authorisation is needed. Subject to availability at Network Optometrists only.
Cover for black and white X-rays and soft tissue ultrasounds. This cover only applies when referred to a Network Radiologist by a Network Doctor.
Blood tests are covered at any Network Pathology Lab when requested by a Network Doctor. According to a list of approved pathology codes.
Two 2D sonar scans per pregnancy. The scans must be done at:
Our Network ensures that you always have access to private healthcare. Contact Get Medical Insurance for a free Medical Insurance quote. Contact Get Medical Insurance for a free Medical Insurance quote.