Get medical cover from R1 200 per month

As your family grows, so does the cost, but with Essential Med, you won’t need to worry about surprise medical expenses. Our Couple with Two Children Plan offers comprehensive day-to-day benefits and hospital cover to cater for the entire family.

Growing costs at home coupled with school requirements and everything in between showcases just how demanding life can be. Whether you have a young child that requires regular GP visits due to niggles and colds picked up at nursery school, or just want coverage in the event of an emergency, we can assist.

This plan has been thoughtfully pieced together to create a product that perfectly fits the needs of each member of the family. And added to this, you can tweak the benefits as you see fit to ensure that you get medical cover that is as special as your family is.

Check out the full list of benefits below:

Day-to-Day Cover

GP Visits

Unlimited Managed

Cost of GP consultations within the Essential Med GP Network is covered under this benefit. 30 day waiting period is applicable.

Acute/Chronic Medication

Unlimited Acc To Formulary

Acute Medication: The extensive Essential Med Acute Medication Formulary is applicable. 30 day waiting period applies.

Chronic Medication: An extensive list of chronic medication is available in the event of you being diagnosed with a chronic condition. The Essential Med Chronic Medication Formulary is applicable. 6 month waiting period applies.

Over-the-Counter(OTC) Benefit: Sometimes you don’t need to go to a doctor to know that you have the flu – OTC meds will help alleviate the symptoms. Give us a call and we will authorise OTC meds for you. 30 day waiting period applies. R100 limit per month.

Pathology & Radiology

Included As Standard Benefit

Should your doctor require you to have blood tests or X-rays done, an extensive list of covered items is available. 30 day waiting period applies.

Dentistry

Benefit Level 1

Managed unlimited dentist consultations and procedures as per formulary, including cleaning, pain control, AMALGAM fillings and normal extractions. These services are obtained from an Essential Med network registered provider. 6 month waiting period applies.

Specialist Visits

Benefit Level 1

If your doctor requires you to be seen by a Specialist, an annual benefit amount of R1000 is available to help cover these costs. 3 month waiting period applies.

Optometry

Basic Optometry & Vision

Your Optometry benefit includes an eye test per beneficiary and free single vision lenses and frames every 24 months. 12 month waiting period applies.

Hospital Cover

Accident Hospitalisation

Benefit Level 1

Cover to the amount of R75 000 per event for single policyholder with Annual Overall Limit (AOL) of R150 000. R150 000 per event for families subject to AOL of R300 000. No waiting period applicable.

Illness Hospitalisation

Benefit Level 1

1st 24hrs: up to R6 500
Day 2: up to R4 500
Day 3: up to R4 500
Day 4 onwards: up to R1 500 per day, maximum of 21 days’ total admission.
The above amounts are applicable in the event of planned hospitalisation. Subject to 3 month waiting period.

Emergency Casualty Visits

Benefit Level 1

For those after hour emergencies that are never planned for and don’t require admission, we offer generous cover to help pay for costs at Casualty Rooms up to R2000 in total per annum. No waiting period applies in cases of accident – 30 day waiting period if due to illness.

Dread Disease

Benefit Level 1

Benefit as extension to Illness (select Illness to make this option available) Heart Attacks, Coronary Heart Disease, Stroke, Cancer and Kidney Failure are a few of the conditions that are covered by this Benefit. R9 000 a day while admitted for a confirmed Dread Disease and up to the maximum benefit limit of R185 000 will be paid out according to the staging of the disease. 12 month waiting period applies. 24m if pre-existing condition.

Permanent Disability

Benefit Level 1

Should an accident occur that results in permanent disability, for example a loss of a limb, a Permanent Disability Benefit amount of up to R200 000 will be paid out less costs already paid. Main member only. No waiting periods applied.

ICU Care

Benefit Level 1

In the event that you are admitted to ICU or High Care, a Daily Benefit amount of R12 500 will be available to cover these costs. No waiting period applies in cases of accident – 3 month waiting period if due to illness.

Funeral Benefits

Funeral Policy - 3m Waiting

A Funeral Benefit of R10 000 will be paid out within 48 hours upon receipt of all required documentation. A 3 month waiting period is applicable to death due to natural causes. No waiting period in the event of death due to accident.

Give your family the gift of good health by choosing the Couple with Two Children Plan at Essential Med.

* approximately – prices may vary on application based on choices