Day-to-day benefits
Colds and flu, tummy bugs, allergies, routine health checks and more, these out-of-hospital medical needs are taken care of with unlimited access to a network of more than 3000 health practitioners nationwide. All that is needed for free consultation and medication from any of these Care Cross healthcare professionals is your Essential Med card and policy number.
Great benefits include:
- Unlimited GP visits: you may visit your chosen network-registered doctor (GP only) as many times as you need to. Your doctor will provide services and prescribe medication according to the list of specified generic medications on the Care Cross medicine formulary. No cash payment is required and medication and small procedures are included.
- Partial cover for after-hour or out-of-network emergency consultations: should you need to visit a doctor (GP only) after hours or while away from your normal area of residency, you are entitled to three out-of-network GP visits per year with an annual limit of R1000 per family. You will need to pay for the treatment and services rendered and then claim the money back from Essential Med.
- Unlimited GP routine maternity check-ups, medication and tests: maternity benefits include prenatal care – which covers all GP visits. Pathology blood tests for Monoclonal Immunological, Down’s syndrome screening (second trimester) and Alpha-feto Protein are also included. Our postnatal benefit is not specifically defined, but is instead included in the GP’s general scope of services, with blood tests subject to the pathology and radiology lists (for example, Pap smears are included as part of postnatal and general benefits) – giving you flexibility and choice in making your own healthcare decisions.
- 2 referred growth sonars (x2): Essential Med also makes provision for two growth sonars (with network providers) during each pregnancy.
- Unlimited prescribed and acute medication:all acute medication linked to the network-registered GP consultation is covered. No over the counter benefit is available. Acute medication is subject to the acute medication formulary and is usually dispensed by Care Cross network GPs. If the GP is a scripting doctor, medication may be obtained from a network pharmacy (Dischem, Clicks or Medi-Kredit pharmacy)
- Unlimited chronic medication upon successful registration and approval: our unique chronic benefit structure includes all chronic medication liked to your network-registered GP consultation subject to the medication formulary. The Care Cross chronic medicines formulary is a list of medicines which are fully covered (if prescribed by your Care Cross doctor) for conditions on the chronic conditions list. No over the counter medication benefit is available. Chronic medication is subject to registration and approval. If approved your medication will be couriered to the nominated address.
- Basic dentistry, including dentist consultations and procedures (network-registered): includes cover for consultations, cleaning, pain control, fillings and extractions. These services must be obtained from a network-registered dentist.
- Annual eye test per beneficiary and free lenses, contact lenses and frames every 24 months: Services must be obtained from a network-registered optometrist. There is a limit in place on prescriptions of white standard mono- or bifocal- lenses with basic frame.
- Unlimited referred black & white X-rays and blood tests: these benefits are unlmited when referred by a network-regstered GP according to a list of approved codes from the radiology and pathology formulary.
Find a Care Cross-registered health professional and registered pharmacy in your area
Important Facts
- Please note: this is not a Medical Scheme; it is a pre-paid Preventative Health Care Service.
- You and your spouse / partner must be younger than 55 years of age when you join.
- Benefits are effective 30 days after inception of your policy; the optometry benefits are available after 12 months.
- Please refer to the user guide for any exclusion.
Call us now to discuss the best policy option for you and your family: 0860 900 900 or apply online.
