PLATINUM - 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
We have over 3,500 Unity Health network doctors nationwide. For your nearest network doctor call our Call Centre on 086 136 6006 or search for a network doctor on your Unity Health App.
You have unlimited GP Visits, but Pre-Authorisation required. First call the Call Centre, select option 2 to the Nurse Call Centre, then option 1, for authorisation.
Where the nurse can’t assist, an Authorisation SMS will be sent to you to consult with a Network Doctor.
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 R345 per visit and limited to 2 out-of-network visits per person per year
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).
You have unlimited virtual GP consultations when referred and facilitated by a nurse at an approved pharmacy. The nurse will first discuss your health concerns and determine if a virtual consultation is necessary
Specialist
Consultation
Limited to R1 675 per visit with an overall limit of R3 500 per family per year. Referral by Unity Health Network GP and pre-authorization required.
Acute Medication
Dispensing GP: This means your GP dispenses medication and will provide you with the necessary medication.
Non-Dispensing GP: Unlimited
Limited to medication prescribed during your Network GP visits.
This means your Network GP does not provide you with medication but will provide you with a prescription to collect your medication.
Available at approved pharmacies (Clicks, Dischem & Pick n Pay).
Chronic Medication
Chronic Medication Programme: 27 Listed “high impact” Conditions2 HIV/AIDS included. Chronic condition: A condition / disease that lasts for an extended period of time.
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.
Approved pharmacies include Clicks, Dischem, Pick n Pay & Medicross.
1Asthma; Chronic Obstructive Pulmonary Disorder; Diabetes Type 1&2; Epilepsy; HIV/AIDS;
Hyperlipidemia; Hypertension; Tuberculosis; 2 Addison’s Disease; Asthma; Bi-polar Mood Disorder; Bronchiectasis; Cardiac Failure; Cardiomyopathy Disease; Chronic Renal Disease; Coronary
Artery Disease; Crohn’s Disease; Chronic Obstructive Pulmonary Disorder; Diabetes Insipidus; Diabetes Type 1 & 2; Dysrhythmias; Epilepsy; Glaucoma; Hemophilia; HIV / AIDS; Hyperlipidemia; Hypertension; Hypothyroidism; Multiple Sclerosis; Parkinson’s Disease; Rheumatoid Arthritis; Schizophrenia;
Systemic Lupus Erythematosus; Tuberculosis; Ulcerative Colitis.
Basic & Emergency Dentistry Treatment
Limited to R1 550 per person per incident with overall family limit of R4 650 per year.
Treatment includes full mouth assessment, intra oral radiographs, scale & polish, extractions, emergency root canal treatment, fillings, pain and sepsis treatment.
Only available at Unity Health Dentists. Specialized dentistry/treatment, such as bridgework or crowns; orthodontic treatment; and dentures are not covered.
Pathology
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
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
3 gynecologists visits, 3 x 2D ultrasound scans per year. Limited to R4 175 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
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 R1 675 000 per person per incident. Pre-authorization is required.
Out-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 R105 000 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 8 350 per person per incident. Pre-authorization is required.
The actual cost of a MRI or CT scan necessitated as a result of an injury sustained due to an accident. Limited to R22 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 175 per person per year. Pre-authorization is required.
Limited to R40 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.
Permanent & Total Disability (Accident Only)
R40 000 payable in the event of the principal insured member becoming permanently and totally disabled and unable to perform their own or similar occupation as a result of an accident.
Family Assistance Benefit
Limited to R1 500 per day, up to R4 500 per admission, subject to an annual limit of R20 000 per family.
Payable to a family member or friend nominated by the insured person for reasonable travel and accommodation expenses incurred when supporting the insured person in hospital.
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.