Please note that the benefit and amounts are dependent upon the cover you have selected. We will gladly assist you in increasing or adding additional benefits to ensure that you are receiving the best cover.
May I move from a Medical Aid to a Medical Insurance?
Yes, you may, but you do need to understand that Medical Aid and Medical Insurance offer different benefits and cover
What is the difference between Medical Aid and Medical Insurance other than the premium?
Medical Insurance is based on events and stated benefits and is regulated by the FSB, Long Term and Short Term Insurance acts. Medical aid is based on procedures and tariff codes and is regulated by the Council of Medical Schemes.
Do I have to be a member to cover my children?
No, you don’t. We allow children to be covered without an adult as a main member. Please note that we do not include funeral or permanent disability cover on Policies that only have junior members on.
May I take out a Policy for a family member and pay for it from my bank account?
Yes, you may. We will contact you though to confirm bank account details and to obtain authorization from you to debit your account.
If I am not a South African Citizen may I take out an Essential Med Policy?
Yes, you may.
What happens if I need to urgently see a doctor after hours because I am ill?
If you have taken the casualty room benefit, please contact our pre authorization department which is available 24/7. They will assist you accordingly.
What happens if I am ill or have an accident outside of South Africa?
Cover is only available within the borders of South Africa, Lesotho and Swaziland. You will need to arrange to come back to South Africa to receive treatment.