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Cover for everyday medical expenses

Your everyday medical expenses (such as GP consultations and medicine) are covered from day-to-day benefits that differ per plan.

How does your cover for these services work?

The cover you will enjoy for day-to-day medical expenses depends on your plan, so ensure you choose a plan based on your specific healthcare needs and preferences. Your day-to-day benefits include cover for:

  • Consultations at GPs and specialists
  • Over-the-counter medicine
  • Acute and chronic medicine prescribed by your doctor
  • Dental services
  • Eye tests, contact lenses and spectacles
  • Blood tests
  • Physiotherapy
  • Dietician visits
  • X-rays and scans
  • Medical appliances

Here is how Medihelp covers these expenses:

Members who prefer to have fixed amounts available for specific healthcare services should choose a plan that offers fixed benefits. Some of these benefits are available as pooled amounts that you or any of your registered beneficiaries can use.

A medical savings account gives you the freedom to use your available funds for medical services or co-payments. You have the entire year’s savings funds available immediately at the beginning of the year. Any unclaimed funds in your savings account are automatically carried forward to the next year, allowing you to build a nest egg for future medical expenses.

Some plans offer a combination of fixed benefits and a savings account, giving you the best of both worlds. You can then enjoy the flexibility of a savings account and the assurance of fixed benefits for certain services should you deplete your savings account.

All Medihelp’s plans also include a separate basket of added insured benefits, which covers routine preventive health screenings, women’s and men’s health tests, and maternity and child medical expenses. Click here to read more.

What is the care extender benefit?
All Medihelp’s plans (except for our entry-level plan) offer a care extender benefit, which stretches your benefits and gives you even more cover. You will receive one additional GP consultation for the family once you or one of your registered family members undergoes a specific preventive care health test and claims the test from your preventive care benefits. You will also get an additional R450 for the family to use for non-prescribed medicine once you or one of your beneficiaries undergoes the combo health screening and claims this from your preventive care benefits.

READ MORE ABOUT PREVENTIVE CARE AND HEALTH SCREENING BENEFITS

How the different plans offer day-to-day benefits

MedVital
This plan offers a benefit for GP and specialist consultations, physiotherapy, acute medicine and self-medication and visits to emergency units. A single member has R1 300 available and a family has R2 600 for the year. Other benefits include the care extender benefit and cover for contraceptives, routine health tests and more.
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MedAdd
MedAdd’s 15% savings account is enriched with separate dental and eye care benefits, cover for contraceptives and excellent maternity and baby benefits. Once the savings account is depleted, a fixed benefit of R1 300 for a single member and R2 600 per family will be unlocked. You have the entire year’s savings funds available upfront. Unused funds earn interest and are carried over to the next year.
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MedSaver
This savings plan offers a generous 25% savings account for out-of-hospital medical expenses. Savings funds not used earn interest and are transferred to the next year. In addition to the care extender benefit, the plan also offers a separate basket of benefits for maternity and baby-related expenses, routine health screenings, immunisation and more.
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MedElect
MedElect’s quality networks ensure that families enjoy comprehensive cover for medical services such as doctors’ consultations, medicine, dental and eye care, and other benefits such as the care extender. Out-of-network benefits are available for those times when members are unable to visit their local network doctors. MedElect members have access to the same extensive added insured benefits as Medihelp’s other plans, including maternity and baby benefits, routine screening and preventive care tests.
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MedPrime
MedPrime is enriched with a 10% savings account, and once the savings account is depleted, you enjoy a day-to-day benefit of R6 300 per person and R11 500 pooled per family. You can use these benefits for GPs, specialists and medicine. MedPrime also offers separate benefits for dental and eye care, the care extender benefit and a wealth of insured benefits offered in addition to your existing benefits.
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MedElite
This plan offers a generous 10% savings account for day-to-day medical expenses. Unused funds earn interest and are carried forward to the next year. Once you have used all your savings, an annual day-to-day benefit of R12 600 per member and R16 700 for a family of three becomes available. MedElite also offers separate benefits for acute and non-PMB chronic medicine, dentistry and optometry. The care extender benefit is available to members of this plan.
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