It is important to note that primary health care insurance schemes are not a medical scheme. The cover is not the same as that of a medical scheme and they are not intended to be a substitute for medical scheme membership.
However, primary health care insurance schemes do provide quality, affordable access to private healthcare for employees who are unable to access medical scheme benefits because of affordability – hence the other name for these schemes – low cost medical insurance.
Entry level schemes, which start at around R186.00 per member per month, provide extended day-to-day benefits and buy-up options are available at an additional cost. Wellness screening, funeral cover and accident cover are some examples.
The benefits provided by these schemes are extensive and offer “good value for money”. Examples of the extent of the cover are:
Access to national provider network;
GP, nurse, gynae & specialist consultations;
Chronic medication for up to 27 conditions;
Dental & eye care;
Private hospital cover for emergencies and accidents;
Casualty visits & 24-hour medical emergency services;
Employee wellness days;
Employee Assistance Programs;
*These are estimates based on weighted average premiums of various plans across four prominant providers in the market. Pricing varies and is subject to demographics and group sizes.