Benefits

One of the primary reasons South Africans look into health cover is because of the escalating prices of a simple consultations with their general practitioner (GP). Medical costs are soaring in the country and old fashioned insurance models, which lock a member into an expansive policy with expensive benefits which they may not really need, aren’t the flexible solution that’s needed in the current economy.

This is exactly why Essential Med allows you to create your own customised policy which includes only the benefits you want, allowing you to control the cost of your medical cover. With Essential Med you’re able to visit your chosen network-registered GP as many times as you need to, and at no additional cost. In fact, we want you to see your GP because prevention is better than cure. Your doctor will provide healthcare services and dispense or prescribe medication, with no cash payment involved, and medication is included. Your visits are managed which means that you will require authorisation after the 5th visit for individual members and the 12th visit for families. This managed approach helps us give you clinical assistance, should you need it.

Perhaps one of the best parts is that you can even go outside of the network and visit the doctor of your choice and claim back the benefit afterwards, at which point Essential Med will contribute to a portion of the consultation cost. In that event, it’s important to note that if your GP charges a higher rate than the agreed tariff you’ll be responsible for the difference. From sign up there’s only a 30 day waiting period before your health cover is activated when it comes to GP visits, but from then on it’s all covered.

We offer these generous policy benefits because we feel it’s important that you see your GP regularly. It just makes good sense.