BRONZE - Primary & Hospital Care
Benefits of the Primary Care as well as Hospital Care packages are combined to give your the best!
Educational Discounts
Get up to 10% Discount on over 1,000 study courses at CTU Campuses in SA.
Short Term Insurance
You qualify for our special rates on personal motor & household and business insurance through Your Broker House FSP46444.
Monthly
eCoupons
Save up to R 750 on your monthly spending by using our ecoupons on a range of products which are redeemable at selected Shoprite, Pick n Pay and Dischem stores.
Life Insurance
You qualify for up to 10 million rand life cover without any medical examination.
Call a Teacher
Available on all 12 school subjects in all 11 languages. Your children and grandchildren have access to book a Teacher to help them with homework, research for school project and preparing for exams, Mondays to Thursdays between 6pm to 9pm. Help is just a call away.
Bond Originator Services
Our Bond Originator Partners will assist member at no charge with their full Bond Originator Services.
Free Will & Testament
Your Broker House will draw up members last Will & Testament at no charges.
Unlimited GP Consultations
Unlimited visits at any Unity Health GP Network.
A R65.00 co-payment is payable for each visit
GP Procedures
Minor procedures in doctors’ rooms are included in GP visits e.g., wound stitching, applying a cast to a broken arm, circumcision, etc.
Out Of Network GP Visits
Payable up to a maximum of R330 per visit and limited to 2 out-of-network visits per person per year. You have to pay upfront and claim back from Unity Health.
GP Visits – Intercare online
No Benefit
Telemedicine
Consultations
Unlimited virtual GP consultations. – Available through approved pharmacies that have a nurse clinic and are partnered with Healthdoc, AlphaDoc or Udok. If the nurse believes a virtual GP consultation is necessary, the nurse will facilitate a video consultation with the GP.
Nurse and Telemedicine
Consultations
Unlimited. No pre-authorisation is required. You have unlimited consultations with a nurse at approved pharmacies (Alpha Pharm, Clicks, Dischem, Local Choice or Medicare). During your consultation nurses can provide acute medication up to Schedule 2 (subject to the acute formulary).
Specialist
Consultation
No Benefit
Acute Medication
Dispensing GP: This means your GP dispenses medication and will provide you with the necessary medication. Non-Dispensing GP: Unlimited medication prescribed during your Network GP visits. This means Network GP does not provide you with medication but will provide you with a prescription to collect your medication. Available at pharmacies per Mediscor formulary (Clicks, Dischem & Pick n Pay).
Chronic Medication
Chronic Medication Programme: Your Network GP will assist you to register on the Chronic Medication Programme with Mediscor. Your prescribed chronic medicines will be covered according to a set formulary. Find the chronic medication formulary (list) on Mediscor’s website: www.mediscor.co.za. Chronic condition: A condition / disease that lasts for an extended period of time.
Basic & Emergency Dentistry Treatment
Pre-Authorisation required
No Benefit
Optometry
No Benefit
Pathology
Basic list of blood tests at a Designated Service Provider.
Your Network GP must ask for these tests to be done. E.g., blood sugar or cholesterol tests.
Only through Ampath Laboratories or Lancet Laboraties or PathCare
Radiology
Black & white X-rays only at a Designated Service Provider. Your Network GP has to refer you to have X- rays done. Specialized radiology such as MRI / CT scans is not covered.
Maternity
Maternity 3 gynecologists visits, 3x2D ultrasound scans per year. Limited to R4,000 per family per annum. Pre-authorization is required.
Pap Smear
Available once every 3 years after the age of 21 at Approved pharmacies (Clicks, Dischem & Pick n Pay). Your Network GP may offer Pap Smears.
Vaccination Program
Influenza: Available annually – needs to be administered by 31 May each year. Tetanus: Available once every 10 years. Hepatitis A & B: Available once-off.
Pneumococcal: Available once every 5 years for those aged 60 or older and for those individuals with medically proven compromised immune system.
Available at Approved pharmacies (Clicks, Dischem & Pick n Pay)
Overall Annual Limit
No Overall Annual limit
In-Patient Hospital Treatment Accident Only The actual cost of hospitalization as an in-patient, including all associated services during the hospital admission at a private facility in the event of injuries sustained due to an accident. “What is an accident?
An accident means bodily injury caused by violent accidental and external physical means. E.g. Severe injuries resulting from a vehicle accident or working with factory machinery.”
Limited to R325 000 per person per incident.
Pre-authorization is required.
In-Patient Hospital Stabilization Emergency Only
The actual cost of hospitalization as an in-patient, in the event of an emergency that necessitates the stabilization of the patient before the patient is transferred to a public hospital. Medical procedures are excluded.
“What is an emergency?
An event or unexpected health condition, which if not treated immediately would result in death or serious bodily impairment. E.g., Heart attack/stroke.”
Limited to R31 500 per person per incident. Pre-authorization is required.
The benefit payable for injuries sustained as a result of a minor accident shall be limited to treatment received in a hospital emergency unit. Pre-authorization is required.
Limited to R 8 000 per person per incident. Pre-authorization is required.
The actual cost of a MRI or CT scan is necessitated as a result of an injury sustained due to an accident.
Limited to R21 000 per person per year. Pre-authorization is required
Physiotherapy & Occupational therapy following an in-patient hospitalization due to an accident.
Limited to a period of 3 months following the discharge from an in-patient hospitalization incident and limited to R4 000 per person per year. Pre-authorization is required.
Limited to R35 000 per principal insured and first spouse dependent and R10,000 per child dependent.
Emergency Evacuation, including ambulance services (air or road) Inter-hospital transfers,
Repatriation of mortal remains, Telephonic Medical advice (Ask a Doctor, ask a Nurse),
Unity Health push to call emergency dialing and find a provider app.
Special Notes
- Make sure of the option you choose.
- There is a R 100.00 non-refundable Joining Fee.
- The first month is a registration month where not all the benefits will be active.
- Only 1 month waiting period.