What is an emergency?
An event or unexpected health condition, which if not treated immediately, would result in death or serious bodily impairment. E.g. Heart attack or stroke.
What is an accident?
An accident means bodily injury caused by violent accidental and external physical means. E.g. Motor vehicle accident, burns, injuries from a crime, snake bite, or injuries from a fall.
What does ‘Principal Insured Person’ mean?
What is meant by ‘Adult Dependent’?
What does ‘Eligible Child’ mean?
What is a “Senior Extender”?
The senior premiums are specifically designed for our clients over 56. This policy is subject to open enrolment, community rating and cross-subsidisation. These additional premiums may be waived if the applicant can demonstrate healthcare insurance coverage for 15 or more years since the age of 35.
What does ‘Insured Person’ mean?
What does “Network” mean?
A selected group of service providers with which the Underwriting Manager has a contract.
What does “Medical Treatment” mean?
Any form of investigation or examination by or consultation with or a surgical procedure performed by a Medical Practitioner for the purpose of treating or monitoring an Insured Person’s medical condition.
What is an acute condition?
A short-term condition or illness like a chest infection, sinusitis or the flu. Your GP can give you acute medication to treat your condition/illness, or write a script for you to get the medication at a pharmacy.
What is a formulary?
A medicine formulary is a list of approved medicines. Only medications that are on this list will be covered. This ensures that premiums stay affordable.
What is a chronic condition?
A condition or disease that lasts for an extended period of time.
What does “Waiting Period” mean?
The period from the policy commencement date or the date an Insured Person is added to this policy until benefits become payable under this policy.
MEDICAL INSURANCE DISCLAIMER: This is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership. The benefits are subject to waiting periods and applicable limits. These are outlined in the policy wording which you are required to read and understand. T&Cs apply. The increase would be based on risk and inflation rates. This is not your policy wording and for the full disclaimer please go to www.elixi.co.za/disclaimer-notice
GAP COVER DISCLAIMER: This is not a medical scheme and will not be a substitute for medical scheme membership. It fills the GAP between what is covered by your Medical Aid, and the actual amount charged by your medical practitioner for in-hospital procedures. This is not your policy wording and for the full disclaimer please go to www.elixi.co.za/disclaimer-notice
Please note that the premiums presented on this website are based on the current rates and is subject to an increase which should take place in December 2019. The increase would be based on risk and inflation rates.
Constantia Insurance Company Ltd – an authorised FSP 31111. Talksure Trading (Pty) Ltd – an authorised FSP 42788. Ambledown Financial Services (Pty) Ltd – an authorised FSP 10287.