Wellness

Essential Plan

Preserve your employees’ health with affordable plans that cover wellness services and facility treatment. Essential Employee Benefits is insurance based and is NOT a medical aid.

DESCRIPTION DETAIL VISITS PER ANNUM VALUE PER DEPENDENT WAITING PERIOD
Basic Wellbeing General Practitioners UNLIMITED Unlimited visits to network GPs NONE
Advanced Wellbeing All specialist As per annual financial R2000 per member per annum 90 Days
Dental Dentist 2 checkups per annum Incl. scaling, polishing, extractions, fillings Agreed network tariff NONE
Optometry Optometrist One eye test every 24 months Agreed network tariff NONE
Optometry – Glasses Glasses 1 set per 24 month period Agreed network tariff NONE
Pathology Blood tests UNLIMITED As per formulary NONE
Radiology Basic black and white scans UNLIMITED As per formulary NONE
Maternity Pregnancy 2 growth scans & UNLIMITED antenatal medication As per formulary NONE
Medication – Chronic Chronic CDL UNLIMITED As per medicinal formulary NONE
Medication – Acute Acute medication R1000 per annum As per medicinal formulary NONE
Emergency Services Emergency UNLIMITED Transportation to Hospital NONE
Trauma Room Access Emergency R2500 per annum Stabilisation NONE

Cost Per Month

Cost per month per Main Member R295
Add Spouse R243
Add Child R160
Senior plan (from age 65) Main Member R550
Dependant R420

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DESCRIPTION DETAIL VISITS PER ANNUM VALUE PER DEPENDENT WAITING PERIOD
Basic Wellbeing General Practitioners UNLIMITED Unlimited visits to network GPs NONE
Advanced Wellbeing All specialist As per annual financial R2000 per member per annum 90 Days
Dental Dentist 2 checkups per annum Incl. scaling, polishing, extractions, fillings Agreed network tariff NONE
Optometry Optometrist One eye test every 24 months Agreed network tariff NONE
Optometry – Glasses Glasses 1 set per 24 month period Agreed network tariff NONE
Pathology Blood tests UNLIMITED As per formulary NONE
Radiology Basic black and white scans UNLIMITED As per formulary NONE
Maternity Pregnancy 2 growth scans & UNLIMITED antenatal medication As per formulary NONE
Medication – Chronic Chronic CDL UNLIMITED As per medicinal formulary NONE
Medication – Acute Acute medication R1000 per annum As per medicinal formulary NONE
Emergency Services Emergency UNLIMITED Transportation to Hospital NONE
Trauma Room Access Emergency R2500 per annum Stabilisation NONE

Cost Per Month

Cost per month per Main Member R295
Add Spouse R243
Add Child R160
ADMISSION TYPE DETAIL VALUE PER ADMISSION WAITING PERIOD
General Admission Paid out on a daily rate as per formulary Up to R53 000 per illness admission Dread Disease – 6 months
Preexisting Illness – 90 days
ICU Admission Paid out on a daily rate as per formulary Up to R15000 per day (Max 5 days) Dread Disease – 6 months
Preexisting Illness – 90 days
Accident Paid out per event R150 000 per individual per incident
R250 000 per family per incident
Dread Disease – 6 months
Preexisting Illness – 90 days
Dreaded Disease Admission Paid out as per disease stage Up to R250 000 Dread Disease – 6 months
Preexisting Illness – 90 days
Maternity Paid out per event R25 000 – Natural Vaginal Delivery
R35 000 – C-Section delivery
10 Months
Surgery As per stated benefit STATED BENEFIT Dread Disease – 6 months
Preexisting Illness – 90 days
Emergency Services Transportation to Hospital UNLIMITED NONE
Trauma Room Access Stabilisation R2500 per annum NONE

Cost Per Month

Cost per month per Main Member R265
Add Spouse R180
Add Child R120

Click a row and scroll right to left to view all columns

ADMISSION TYPE DETAIL VALUE PER ADMISSION WAITING PERIOD
General Admission Paid out on a daily rate as per formulary Up to R53 000 per illness admission Dread Disease – 6 months
Preexisting Illness – 90 days
ICU Admission Paid out on a daily rate as per formulary Up to R15000 per day (Max 5 days) Dread Disease – 6 months
Preexisting Illness – 90 days
Accident Paid out per event R150 000 per individual per incident
R250 000 per family per incident
Dread Disease – 6 months
Preexisting Illness – 90 days
Dreaded Disease Admission Paid out as per disease stage Up to R250 000 Dread Disease – 6 months
Preexisting Illness – 90 days
Maternity Paid out per event R25 000 – Natural Vaginal Delivery
R35 000 – C-Section delivery
10 Months
Surgery As per stated benefit STATED BENEFIT Dread Disease – 6 months
Preexisting Illness – 90 days
Emergency Services Transportation to Hospital UNLIMITED NONE
Trauma Room Access Stabilisation R2500 per annum NONE

Cost Per Month

Cost per month per Main Member R265
Add Spouse R180
Add Child R120

Combined Essential and Vital Plan

Cost per month per Main Member R480

Comprehensive Cover (Funeral + Wellness)

Cost per month per Main MemberR455

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