Affordable Medical Insurance Plans | Elixi

Get Medical Insurance with unlimited network GP visits
from less than R11 a day!
Avoid expensive medical costs. Fill in your details:

  • Principal members require a minimum monthly income of R8000.
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Medical Insurance from as little as R11 per day? Yes, you heard right! With Elixi Medical Insurance you can enjoy benefits like Unlimited GP (General Practitioner) Visits, Basic and Emergency Dentistry at a network medical professional and so much more!

Quality healthcare is important for you and your family! Don’t let rising medical costs become a concern. Everybody has different healthcare priorities, that’s why our medical insurance plans are designed to suit everybody’s budget.

If you want to avoid expensive medical costs, but still enjoy private medical healthcare, Elixi Medical Insurance can help. We offer affordable medical insurance plans using specific providers in our network for both day to day health care, in-hospital and out-of-hospital treatment in the event of an emergency or accident.

Compare our plans and request a callback, we’ll explain all the benefits and help select the right plan for you.

COMPARE OUR PLANS

BLUE PLAN | Primary Care

BLUE PLAN

Primary Care

starting from R326
Unlimited GP Visits
Limited Acute Medication
Basic Radiology X-rays
Basic Pathology Blood Tests
Pre-Birth Maternity Benefits
Wellness Screenings
Pap Smears
Vaccination Programme
Accidental Death Benefit
Access to Accident & Emergency Services (ER24)
In-Patient Hospital Treatment (Accidents Only)
Out-Patient Casualty Treatment (Accidents Only)
In-Patient Stabilisation (Emergency or Casualty Only)
MRI & CT Scans (Accidents Only)
Physio & Occupational Therapists (Accidents Only)
Optometry
Chronic Medication
Basic & Emergency Dentistry
Specialist Visits
PURPLE PLAN | Primary and Hospital Care

PURPLE PLAN

Primary and Hospital Care

starting from R427
Unlimited GP Visits
Limited Acute Medication
Basic Radiology X-rays
Basic Pathology Blood Tests
Pre-Birth Maternity Benefits
Wellness Screenings
Pap Smears
Vaccination Programme
Accidental Death Benefit
Access to Accident & Emergency Services (ER24)
In-Patient Hospital Treatment (Accidents Only)
Out-Patient Casualty Treatment (Accidents Only)
In-Patient Stabilisation (Emergency or Casualty Only)
MRI & CT Scans (Accidents Only)
Physio & Occupational Therapists (Accidents Only)
Optometry
Chronic Medication
Basic & Emergency Dentistry
Specialist Visits
GOLD PLAN | Primary and Hospital Care +

GOLD PLAN

Primary and Hospital Care +

starting from R508
Unlimited GP Visits
Limited Acute Medication
Basic Radiology X-rays
Basic Pathology Blood Tests
Pre-Birth Maternity Benefits
Wellness Screenings
Pap Smears
Vaccination Programme
Accidental Death Benefit
Access to Accident & Emergency Services (ER24)
In-Patient Hospital Treatment (Accidents Only)
Out-Patient Casualty Treatment (Accidents Only)
In-Patient Stabilisation (Emergency or Casualty Only)
MRI & CT Scans (Accidents Only)
Physio & Occupational Therapists (Accidents Only)
Optometry
Chronic Medication
Basic & Emergency Dentistry
Specialist Visits
BLACK PLAN | Primary and Hospital Care ++

BLACK PLAN

Primary and Hospital Care ++

starting from R665
Unlimited GP Visits
Limited Acute Medication
Basic Radiology X-rays
Basic Pathology Blood Tests
Pre-Birth Maternity Benefits
Wellness Screenings
Pap Smears
Vaccination Programme
Accidental Death Benefit
Access to Accident & Emergency Services (ER24)
In-Patient Hospital Treatment (Accidents Only)
Out-Patient Casualty Treatment (Accidents Only)
In-Patient Stabilisation (Emergency or Casualty Only)
MRI & CT Scans (Accidents Only)
Physio & Occupational Therapists (Accidents Only)
Optometry
Chronic Medication
Basic & Emergency Dentistry
Specialist Visits

THE BENEFITS EXPLAINED

PRIMARY CARE

Unlimited GP Visits

Access to Unity Health Network General Practitioners, at the consulting rooms of the GP during the normal consulting hours of the Network GP.

Minor GP procedures are included in your visits to the GP. For example stitching of a wound, application of a cast to a broken limb etc.

There are over 1700 Network GP’s nationwide.

Unlimited visits per person, per year. Pre-authorisation required for 10 or more GP visits per person, per year.

Acute Medication

Acute medication will be dispensed or prescribed by a Network GP for acute illnesses at one or more consultations if required and subject to a list of medication.

Dispensing GP: If your GP dispenses medication, you will get everything that you need during your visit.

Non-dispensing GP: If your GP does not dispense medication. You will receive a prescription, which you can collect from the pharmacy.

Limited to medicine prescribed during GP visits. Limited per person, per year.

All acute medication is subject to a formulary.

Basic Pathology Blood Tests

Unlimited blood tests are provided if you receive a referral from your Network GP.

Subject to a list of basic blood tests e.g. cholesterol, glucose test.

During your visit, your GP will advise you if blood tests are necessary.

Basic Radiology X-rays

Basic X-rays (black & white) are covered on referral by a Network GP.

Your GP will advise you if X-rays are needed.

Subject to a list of X-ray procedures. Specialised radiology such as MRI, CT scans are not covered.

Pre-Birth Maternity

Black Plan covers 3 gynaecologist visits and 3 ultrasound scans per year, while Blue, Purple and Gold Plans cover 2 gynaecologist visits and 2 ultrasound scans per year.

You may go to any gynaecologist. Upfront payment may be required but will be reimbursed to you. If you prefer to have an ultrasound scan at your Network GP, we will not count this as an additional GP visit.

Limits apply per family, per year.

Wellness Screenings

Wellness Screenings include health checks for:

  • Blood pressure
  • Cholesterol
  • Glucose levels
  • Body mass index (BMI)
  • Waist circumference
  • HIV and pre & post-test counselling

Available at your nearest Dischem and Clicks pharmacies.

Limited to one screening per person, per year.

Accidental Death Benefit

A benefit is payable in the event of the death of the principal insured person and/or the spouse of the principal insured person due to an accident.

Limited to one spouse.

Chronic Medication

Black and Gold Plans offer access to chronic medication. Covers medication for the following specified “high-impact” chronic conditions:

  1. Asthma
  2. Chronic obstructive pulmonary disorder
  3. Diabetes (type 1&2)
  4. Epilepsy
  5. HIV/AIDS
  6. Hyperlipidemia
  7. Hypertension
  8. Tuberculosis
  9. Hypothyroidism (Black Plan only)
  10. Glaucoma (Black Plan only)
Basic and Emergency Dentistry

Access to a Unity Health Network Dental Practitioner or Unity Health Network Dental Therapist and subject to a list of dental procedures.

Treatment includes:

  • Full mouth assessment
  • Intraoral radiographs
  • Scale and polish
  • Extractions
  • Emergency root canal
  • Fillings
  • Pain and sepsis treatment

Specialised dentistry (such as bridges or crowns) is not covered. Orthodontic treatment (such as braces or dentures) is not covered.

There are over 2 200 network dentists nationwide.

Limits apply per person and family, per year.

Basic Optometry

Access to a PPN network optometrist for an annual optometric wellness examination.

And, if required, a standard frame to the value of R254 and one pair of clear standard spectacle lenses per person, per 24 months subject to the qualifying norms.

One eye test per person, per year.

Specialist Visits

Subject to Network GP referral. Specialist visits limited per family, per year.

Pap Smears

Available once every 3 years after the age of 21. Available at Clicks and Dischem pharmacies. Your Network GP may or may not offer Pap smears.

Vaccination Programme

Available at approved Dischem and Clicks pharmacies.

Influenza: Available annually and needs to be administered by 31 May each year.
Tetanus: Available once every 10 years.
Hepatitus A & B: Available once-off.
Pneumococcal: Available once every 5 years for those aged 60 or older and for those individuals with a medically proven compromised immune system.

HOSPITAL CARE

In-Patient Stabilisation - Emergency or Casualty Unit Only

The actual cost of hospitalisation as an in-patient, in the event of an emergency that necessitates the stabilisation of the patient in an emergency unit before the patient is transferred to a public hospital.

Limited per insured person, per incident.

In-Patient Hospitalisation - Accident Only

The actual cost of hospitalisation as an in-patient, including all associated services during the hospital admission at a private facility in the event of injuries sustained due to an accident.

Planned medical procedures are not covered; e.g. hysterectomy, hip replacement.

Limits apply per insured person, per incident.

Out-Patient Casualty Unit - Accident Only

The benefit payable for injuries sustained in the event of an accident shall be limited to treatment received in a hospital emergency unit.

Limits apply per incident.

Accident & Emergency - ER24

Hospital pre-authorisation and guarantee of payment to the treating facility.

Ambulance services (air or road). Telephonic medical advice. Inter-hospital transfers.

Repatriation of mortal remains within the borders of South Africa.

Unity Health push to call emergency dialling, geo-locating and find a provider mobile app.

MRI & CT Scans - Accident Only

The actual cost of an MRI or CT scan necessitated as a result of an injury sustained due to an accident. Pre-authorisation is required.

Limited per insured person, per year.

Physio & Occupational Therapists - Accident Only

Physiotherapy & Occupational Therapy following an in-patient hospitalisation due to an accident.
Limited to a period of 3 months following the discharge from an in-patient hospitalisation incident. Pre-authorisation is required.

Limited per insured person, per year.

VALUE ADDED SERVICES

Call a GP or Nurse

The 24 hour GP helpline is staffed by medical professionals providing advice and assistance to members.

Members will be able to discuss a number of medical-related matters with a qualified GP and or nurse on the following:

  • Medical advice
  • Second opinion
  • Confirmation and clarity of medical diagnosis
  • Guidance on drug regime, guidance to a specialist GP
  • Guidance and advice on the side effects of prescribed treatment
  • Telephonic follow up after diagnosis and treatment.
C5 HIV Prevention Programme

If a member is exposed to HIV through a trauma or assault, the member will have access to:

  • 24 Hour telephonic HIV advice and counselling line
  • Emergency evacuation to HIV treatment facility (ER24 only)
  • Medical consultation
  • 3 Day starter pack
  • 25 Day antiretroviral HIV treatment including, sexually transmitted disease therapy, pathology tests.
Trauma Counselling

If a member is involved in a traumatic event or is witness to a traumatic event, the member will have access to:

  • Unlimited telephonic counselling
  • Referral to a qualified counsellor
  • Face to face counselling with a qualified counsellor

Limits apply per event.

Household Assistance

This service will provide members with a callout and up to one hour’s labour (initial fault only), for emergency events that relate to plumbing, electrical faults, faults with appliances, damage to external windows, and emergencies where a locksmith is required.

Legal Assistance and 30 Minute Free Consultations

Professional, in-house, qualified legal advisors who provide advice to members on any legal topic or matter ranging from debt and divorce to labour and domestic violence, 24/7. The legal service also provides for standard legal documents such as a domestic worker employment contract, maintenance kit, offer to purchase, small claims court kit, Road Accident Fund, etc.

MEDICAL AID VS MEDICAL INSURANCE

Do you know the difference between medical aid and medical insurance? Medical aid schemes are regulated by the Medical Schemes Act. By law, they must include treatment for chronic conditions and a list of in-hospital procedures.

Medical insurance is a stated benefits contract regulated by the Short-term Insurance Act. While medical aid provides comprehensive hospital cover, medical insurance specifies its benefits and pays out a clearly defined amount. Medical insurance plans are geared towards providing day to day health care as a preventative measure.

Take the first step towards a healthier you.

LET US CALL YOU BACK

WHO YOU WILL BE DEALING WITH

Talksure

Talksure Trading (Pty) Ltd is an authorised financial services provider (FSP 42788), and offers broker and intermediary solutions with a range of insurance products, including medical insurance. Talksure takes great pride and responsibility in being an FSP and created the Elixi Medical Insurance brand to meet growing customer demand in the medical insurance space.

Unity Health

Unity Health is a division of Ambledown Financial Services (Pty) Ltd (FSP 10287). Unity have partnered with Elixi Medical Insurance to help create quality health care at an affordable price. Unity are the underwriting managers on behalf of the insurer Constantia Insurance Company Limited (FSP 31111). Unity Health administers the policies sold under the Elixi brand and manage the network of service providers offered by Elixi Medical Insurance.

ER24

Unity Health and Elixi Medical Insurance have partnered with one of South Africa’s top providers of emergency medical services. Their services to Elixi Medical Insurance members includes a 24-hour call centre to deal with emergencies, in-patient and out-patient hospital admissions, verifying membership, and issuing guarantee of payments (GOPs) to Elixi Medical Insurance members.

Not sure which plan is for you?
Let us call you back.