Medical Insurance
Medical Insurance is an insurance product that provides cover for medical expenses. Unfortunately, Medical Insurance is often overlooked or misunderstood. This guide aims to help you understand Medical Insurance. You can then make informed decisions about your medical coverage.
In this guide, we’ll walk you through the basics of Medical Insurance. We’ll also cover some of the most common questions about Medical Insurance.
Are you new to Medical Insurance? Considering switching from Medical Aid? Or looking to understand the available coverage? This guide has everything you need to know.
Let's dive in and explore Medical Insurance together.
The cost of accessing private healthcare in South Africa is notoriously high. The vast majority of South Africans cannot afford access to private healthcare. Medical Insurance gives South Africans an affordable way to access private healthcare.
Medical Insurance covers various day-to-day medical expenses in return for a monthly premium. This means you're covered for things like, doctors visits, basic dentistry and medication. Insurance cover for things like accidents are usually purchased as an extra product.
Medical Insurance helps you take care of your health, without worrying about the cost. Medical Insurance doesn’t give you the same benefits as a Medical Aid. Medical Insurance, however, is a worthwhile option if you can’t afford Medical Aid.
Some of the key points of Medical Insurance include:
In South Africa, the public healthcare system is not up to the standard it should be. This is why many people turn to private healthcare. Medical Insurance guarantees access to private healthcare, giving you the care you need.
With Medical Insurance, you have cover for various day-to-day medical costs. Without Medical Insurance, you may not be able to afford the cost of your necessary medical care. Medical Insurance ensures you can take a proactive approach to your health. This enables you to seek medical treatment at the earliest signs of a health issue.
You need Medical Insurance for the following reasons:
Medical Insurance gives you affordable access to a network of private healthcare professionals. You don’t have to rely on government systems to get you the medical care you need.
Private healthcare professionals often have shorter wait times than government healthcare systems. This can be beneficial if you need treatment for a serious or urgent health issue.
Day-to-day medical expenses can add up quickly if you don’t have Medical Insurance.
Things like doctors visits, dentistry, optometry and medication can break your budget. Medical Insurance gives you financial protection by reducing the burden of medical costs.
Without Medical Insurance, you may avoid seeking medical care. Or if you do seek medical care, you could also end up with large medical bills you can’t afford.
Medical Insurance protects your family. Medical Insurance ensures your loved ones have access to quality medical care. Your family can receive preventive care, medication, and various other benefits. You don't have to worry about the burden of high out-of-pocket costs.
Medical Insurance provides cover for your day-to-day medical expenses. You get access to private healthcare in an affordable way.
If you buy Medical Insurance from Get Medical Insurance, you’re covered for:
We pay for GP visits in our Service Provider Network. This includes minor medical procedures performed in your doctor’s rooms. This GP visit coverage is subject to a list of approved codes.
Connect with a doctor without leaving your home. Doctors can diagnose and treat a wide range of medical conditions remotely. This makes it convenient for patients with busy schedules. Your virtual doctor can provide an electronic script for formulary medicine.
You can visit a nurse that's part of our Service Provider Network. Your nurse visit cover includes visits for the treatment of minor illnesses, including:
You’re covered for two health screenings at a Network Pharmacy Clinic including:
You have cover for Acute Medication. This only applies if:
You're covered for Over the Counter (OTC) Medication from a Network Pharmacy. You can only get OTC Medication at a Network Pharmacy and on advice by the pharmacist.
You’re covered for Chronic Medication if:
After approval of the Chronic Medication, you can obtain your Chronic Medication at:
You’re covered for one flu vaccination per year.
Cover for your HIV programme, including cover for:
One consultation with a Network Dentist for a full mouth examination. One preventative treatment that includes cleaning, scaling and polishing. Fluoride Treatment is also covered for children under the age of 12 years.
Additional consultations when required for:
Certain benefits require pre-authorisation. Treatment Guidelines apply.
You're covered for emergency root canal treatment for pain and sepsis. This benefit requires pre-authorisation
You’re covered for one eye test per year at a Network Optometrist. Pre-authorisation is not required for this benefit.
You’re covered for one pair of glasses every 24-months. This benefit requires Pre-authorisation. Subject to availability at Network Optometrists only.
You have cover for black and white X-rays and soft tissue ultrasounds. This cover only applies when referred to a Network Radiologist by a Network Doctor.
You're covered for Blood tests at any Network Pathology Lab upon request by a Network Doctor. According to a list of approved pathology codes.
You’re covered for two 2D sonar scans per pregnancy. You must have these scans done at:
It’s often hard to find affordable Medical Insurance that covers all your needs. Look no further, Get Medical Insurance has the perfect Medical Insurance plan for you. Depending on the type of Medical Insurance plan you choose, your benefits will vary.
We provide the following Medical Insurance plans:
We understand the importance of having access to private healthcare. Our standard plan gives you access to private healthcare without breaking the bank.
The standard plan costs only R450 per month for an adult, or R315 for a child, per month. The benefits of this plan include:
Our premium plan gives you extensive day-to-day cover for personalised treatment and medication.
The premium plan costs only R620 per month for an adult, or R425 for a child, per month. The benefits of this plan include:
Medical Insurance is an important way to protect your family from the high cost of medical care. You may have some questions about Medical Insurance. That's why we've compiled this list of the most common FAQs. These FAQs can help answer any Medical Insurance related questions you may have.
Everyone needs some form of medical coverage. Medical Aid is often too expensive for the average person. Medical Insurance covers your day-to-day medical expenses. This helps you stay healthy, without breaking the bank.
When choosing a Medical Insurance plan, consider your budget and your health needs. If you need limited cover and can’t compromise your budget, then a standard plan is your best bet. If you require extra cover and you have the budget, a premium plan would suit your needs better.
Yes, you can buy Medical Insurance for someone else. You can help support someone close to you with Medical Insurance. You can support home assistance staff or family with access to private healthcare.
Yes, you can choose your own doctor with Medical Insurance from a list of network providers.
A waiting period is the amount of time that must pass before certain benefits are available. Your waiting period can vary, make sure you know when waiting periods apply.
Waiting periods on all Get Medical Insurance policies are as follows:
When you sign up for Medical Insurance, we determine if waiting periods apply. Waiting periods will not apply to:
We waive your waiting period if you register your child within 90 days of their birth. For older children, you must add your child within 90 days of signing up.
We waive your waiting period if you register your spouse within 90 days of your marriage. A waiting period applies if you do not register your dependent within 90 days.
We waive any waiting periods if you’ve had previous cover. You must provide proof of previous Medical Insurance or Medical Scheme cover. Your previous cover must have been for at least 12 months, with less than 3 months break in cover.
Pre-authorisation is the process of obtaining pre-approval from your Medical Insurance. Pre-authorisation is often required before accessing certain benefits.
Yes. Medical Insurance does cover Chronic Medicine. Our standard plan covers 7 types of Chronic Medicine. Our premium plan covers 27 types of Chronic Medicine.
Yes, Medical Insurance is cheaper than Medical Aid. It’s important to remember, Medical Insurance and Medical Aid are completely different. Medical Insurance usually provides significantly less cover when compared to Medical Aid. That explains why there is a significant price difference between the two.
Yes, Medical Insurance benefits do expire. Your benefits are only valid for 1 year from the date your coverage begins. To take advantage of your benefits, use them before they expire.
You’ve decided it’s time to give your family the cover they need, but you don’t know where to start. Applying for Medical Insurance is simple with Get Medical Insurance.
With Get Medical Insurance, there is a Medical Insurance plan for everyone. We make it easy for South Africans to get affordable Medical Insurance. All you need to do is complete the form below to get a call back from one of our qualified brokers.