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Benefits and services

Medihelp benefits

Medihelp provides comprehensive cover on all benefit options in and out of hospital for COVID-19 which qualifies in terms of prescribed minimum benefits (PMB) criteria. Members of Medihelp's network benefit options can also rest assured that no out-of-network hospital co-payment will apply in the interim should they need to be diverted to a non-network hospital for COVID-19 or any other medical emergency because network hospitals are at full capacity.

COVID-19 related telephonic and video consultations are covered at 100% of the Medihelp tariff. Members of Necesse are required to make use of network GPs to avoid co-payments. You can find a network GP on Medihelp's website at the provider search function at https://www.medihelp.co.za/connect/provider-search.

Medihelp will cover COVID-19 pathology tests, namely the PCR and antigen tests, in full according to the COVID-19 protocol. Members of the Necesse option are required to make use of Lancet or PathCare laboratories and must be referred by a Necesse network GP.

Should you prefer to be tested at a Dis-Chem facility, please contact them directly to make the necessary arrangements. In such cases, you will need to pay Dis-Chem first and then submit a claim to Medihelp.

Should you need to have a COVID-19 test done prior to a planned hospital admission, you should phone the pathology depot to make the necessary arrangements, as some depots do not accept walk-ins. Remember that such tests do not qualify for PMB and will be paid from your benefit option’s available day-to-day benefits for pathology (if applicable).

The vaccination centre where you receive your vaccine will submit a claim for your vaccination and administering of the vaccine to Medihelp and the Scheme will cover the cost as PMB.

24-hour online services for members

Medihelp offers members various options to access information about their membership, claims and contributions. The exclusive Medihelp Zone and app provide you with all the functionalities you need whenever you need it.

Medihelp’s Member Zone is an online self-service website which gives members access to their medical aid details. These include claims statements, available benefits and access to membership information in a secure environment.

Services available

  • See a breakdown of available benefits.
  • Search for a network provider.
  • Request pre-authorisation.
  • Members can view and update their personal information.
  • Register a dependant through an easy to use online application form.
  • View and submit claims.
  • Download a tax certificate.
  • View monthly contributions.
  • View or request a Medihelp membership card.
Members can click here to register on the Member Zone and start using these and other features right away.

 

Members can also use Medihelp’s member app, available on Google Play, iStore and Windows Store. The app allows members to view and share their e-membership card, find a network healthcare provider, view available benefits, submit claims and more.

The Medihelp website also offers members access to quick answers to most frequently asked questions on the Quick Answers functions well as an online chat bot ready to respond to your requests.

Should you need any other information that is not available on these platforms, you are welcome to use the online web chat to talk to an experienced and capable call centre agent online or else contact Medihelp directly during work hours.

 

Medihelp's contact list