1. May I belong to a Medical Aid and have a Primary Care Policy with Essential Med?
Yes, our Primary Care Policy fits in perfectly with a Hospital Plan and a Medical Aid
2. May I go to any Doctor and how many visits do I have?
We have an extensive GP Network which we encourage you to make use of. This will ensure that you are not expected to pay in any differences in charges and the treating GP prescribes medication and treatment that is within our extensive formulary.
There is no limit on the number of visits you are allowed.
3. What happens if I am on holiday and need to see a GP?
Have a look on our website and locate a Network GP where you are. In the event of you not being able to see a Network GP and are asked to pay up front, we will reimburse you up to R250 per visit.
4. What happens if there is no Network GP in my area or my usual GP is not on the Network?
Complete a nomination form or give us a call and we contact your GP and establish if he is willing to join our GP Network.
The same applies to Dentists
5. How do I get OTC medication without seeing my GP?
We understand that you sometimes don’t need to see a GP, but that you need medication to help you get back to peak condition. Simply phone us on 0861 70 70 70, select the relevant option and speak to one of our nurses for an OTC benefit of up to R100.
6. What medication can my doctor prescribe?
Our Network GP’s are encouraged to make use of our Formulary; this is an exhaustive list of medication that we cover.
7. How do I establish if my medication is on Formulary?
8. What do I do if my medication is not covered as per the Essential Med Formulary?
Either the pharmacist may replace the prescribed medication with a generic alternative or you can request your doctor to prescribe an alternative. Your doctor is also well to discuss alternatives with our pharmacy benefit management company, Mediscor. This can be done by phoning 0861 70 70 70 and following the prompts
Need more information?
If you're ready to apply for cover, click the button below. If you have questions we haven't answered, select the call back button and one of our friendly consultants will get in touch.