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Cover for everyday medical expenses

We cover your everyday medical expenses (such as GP consultations and medicine) from day-to-day benefits that differ per plan.

How does your cover for these services work?

The cover you 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 if you choose a plan that offers fixed benefits. Some of these benefits are available as pooled amounts that you or any of your registered dependants 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 at the beginning of the year. Any unused funds in your savings account earn interest and automatically carry over 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, if you deplete your savings account.

All Medihelp’s plans also include a separate basket of added insured benefits that cover routine preventive health care 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 MedMove!) offer a care extender benefit, which stretches your benefits and gives you even more cover. You receive an additional GP consultation for the family once you or one of your registered family members undergoes a specific preventive care health test and you claim the test from your preventive care benefits. You also get an additional R490 for the family to use for self-medication once you or one of your dependants undergoes the combo health screening and you claim 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, self-medication, and visits to emergency units. A single member has R1 450 available and a family has R2 800 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 450 for a single member and R2 800 per family is unlocked. You have the entire year’s savings funds available at the beginning of the year. Unused funds in your savings account earn interest and automatically carry 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. Unused funds in your savings account earn interest and automatically carry over 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 benefit. Out-of-network benefits are available for those times when members cannot visit their local network doctors. MedElect members have access to the same extensive added insured benefits that Medihelp’s other plans offer, including maternity and baby benefits, routine screenings, and preventive care tests.
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MedPrime
MedPrime is enriched with a 10% savings account. Once the savings account is depleted, you enjoy a day-to-day benefit of R6 900 per person and R12 700, 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 10% savings account for day-to-day medical expenses. Unused funds earn interest and carry forward to the next year. Once you have used all your savings, an annual day-to-day benefit of R13 900 per member and R20 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 also available to members of this plan.
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