Overall, the UbuntuMed Primary Care Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and preventative health services for its Family Members. The UbuntuMed Primary Care Plan starts from R435 ZAR. UbuntuMed has a trust rating of 3.
π Medical Health Plan | π₯ UbuntuMed Primary Care |
π€ Main Member Contribution | From R435 |
π₯ Adult Dependent Contribution | From R435 |
πΆ Child Dependent Contribution | From R435 |
π Gap Cover | None |
π· Screening and Prevention | β Yes |
πΆ Medical Savings Account | None |
πΌ Maternity Benefits | βοΈ Yes |
π€§ Chronic Conditions | β Yes |
π‘ Home Care | None |
π The UbuntuMed Primary Care Plan is one of 2, starting from R435. UbuntuMed Primary Care plan offers a range of benefits for those seeking preventative health services and medical consultations. Gap Cover is not available on the UbuntuMed Primary Care Plan.
π However, UbuntuMed offers 24/7 medical emergency assistance. According to the Trust Index, UbuntuMed has a trust rating of 3.
ππΎ UbuntuMed Health Insurance has the following two plans to choose from:
π΄ GP Consultations | You have an unlimited number of visits to any network doctor. Pre-authorization will be required if you visit your network doctor or nurse 10 or more times yearly. You can see out-of-network doctors for a maximum of R330 per visit and are limited to two visits per year. |
π GP In-Room Procedures | Basic medical and surgical procedures can be performed in the doctorβs room, including the following: Circumcision Wound stitching Applying a cast to a broken arm |
π‘ Nurse Consultations | Unlimited nurse consultations available at approved pharmacies (Alpha Pharm, Clicks, Dischem or The Local Choice) for minor ailments. In many practices nurses can provide scripts for minor ailments for up to schedule 2 medications. Pre-authorization is required for each Network GP visit |
π’ Specialist Consultations | Limited to R1,600 per visit with an overall limit of R3,350 per family per year. Referral by network doctor and pre-authorisation required. This benefit will be prorated based on the beneficiary start date. |
π΅ Acute Medication from a Dispensing GP | This means your doctor will dispense and provide you with the necessary medication. |
π£ Acute Medication from a Non-Dispensing GP | Medication prescribed during Network GP visits is unlimited. Medication is covered according to a predetermined formulary. Clicks, Dischem, and Pick n Pay are among the pharmacies that have been approved. |
π΄ Chronic Medication | Chronic Medication Programme: 8 Listed βhigh impactβ Conditions* HIV/AIDS included. *Asthma, Chronic Obstructive Pulmonary Disorder; Diabetes Type 1&2; Epilepsy; HIV/AIDS; Hyperlipidaemia; Hypertension; Tuberculosis. Chronic Medication Programme: Your Network GP will assist you to register on the Chronic Medication Programme with Mediscor. Your prescribed chronic medicines will be covered according to a set formulary. Find the chronic medication formulary (list) on Mediscorβs website: www.mediscor.co.za. Approved pharmacies include Alpha Pharm, Clicks, Dischem or The Local Choice. |
π Basic and Emergency Dentistry | Limited to R1,500 per person per incident, with a total annual cap of R4,500 per family annually. The benefit includes the following: Full mouth evaluation Intraoral radiographs Scale and polish Extractions Emergency root canal treatment Fillings Pain and sepsis treatment This benefit is only available to participating dentists. Bridgework and crowns, orthodontic treatment, and dentures are not covered. |
π‘ Optometry | Limited to One eye examination per person per year. An R599 standard frame and one pair of clear standard spectacle lenses per person per 24 months. The benefit is available from PPN Network Optometrists. |
π’ Pathology | A basic list of blood tests available from a Designated Service Provider. Your Network GP must request these tests. |
π΅ Radiology | Only a Designated Service Provider can offer services. Limited to black and white X-rays. Your Network GP is required to refer you for X-rays. MRI/CT scans and other specialized radiology are not covered. |
π£ Maternity | Each pregnancy is limited to two gynecologist visits and two ultrasound scans. Pre-approval is required. The annual limit is R4,000 per family. |
π΄ Health Screenings | Each person is only allowed one screening per year. Approved pharmacies for this include Clicks, Dischem, and Pick n Pay. |
π Preventative Care | Health screenings include examinations for the following: Blood pressure Cholesterol Glucose levels BMI Waist circumference HIV/AIDS (including counseling before and after testing) |
π‘ Pap Smears | Available to female insured persons from 21. Benefit available every 2 years. Available from Clicks, Dischem, and Pick n Pay pharmacies. |
π’ PSA Screening | Male-insured persons can use this benefit every two years. Available at approved pharmacies (Clicks, Dischem, and Pick n Pay). |
π΅ Vaccination Program | – |
π£ Flu | Influenza vaccines are available every year and must be administered by May 31. |
π΄ Tetanus | Tetanus vaccines are only available once every ten years. |
π Hepatitis A and B | Hepatitis A and B vaccines are only offered once-off. |
π‘ Pneumococcal | Available once every 5 years for those 60 and older and those with a medically proven compromised immune system. Approved pharmacies include Clicks, Dischem, and Pick n Pay. |
π’ Assistance Program (AP) | Registered counselors who follow specific procedures and clinical protocols provide unlimited telephonic or Skype counseling services. The service is available 24 hours a day, seven days a week, and includes counseling for the following: Counseling for critical incidents and trauma HIV counseling Legal Counsel Financial Guidance Face-to-face counseling can be arranged on your behalf. |
ππΎΒ Consider adding GAP Cover ? Read more about the Best Gap Cover with No Waiting Period
π The services, conditions, or events listed below are permanently excluded from coverage.
π Waiting periods for UbuntuMedβs health insurance policies vary depending on the type of coverage and policy. Here are some typical UbuntuMed wait times:
π Finally, A 12-month waiting period is usually required for pre-existing conditions.
ππΎ READ more about the 5 Best Hospital Plans for Students and Young Adults
π Medical Health Plan | π₯ UbuntuMed Primary Care | π₯ EssentialMED Day-to-Day | π₯ GetSavvi Health Primary Care |
π€ Main Member Contribution | From R435 | R445.50 | From R620 |
π₯ Adult Dependent Contribution | From R435 | R445.50 | From R977 |
πΆ Child Dependent Contribution | From R435 | R223.50 | From R839 (single member) and R1,195 (family) |
π Gap Cover | None | None | None |
π· Screening and Prevention | β Yes | β Yes | β Yes |
πΆ Medical Savings Account | None | None | None |
πΌ Maternity Benefits | βοΈ Yes | βοΈ Yes | βοΈ Yes |
π€§ Chronic Conditions | β Yes | β Yes | β Yes |
π‘ Home Care | None | None | None |
ππΎ POLL: 5 Best Medical Aids under R1000
π The UbuntuMed Primary Care plan is a health insurance option that covers day-to-day medical expenses, maternity care, screening and prevention services, and consultations with GPs, Nurses, and Specialists.
π Some of the benefits of this plan include access to preventative health services and the ability to consult with a wide range of medical professionals.Β However, it is essential to note that this plan does not include hospital coverage or provide benefits for MRI or CT scans, oncology treatments, or other similar medical services.
π Additionally, it is possible that the coverage provided by this plan may not be comprehensive enough to meet the needs of everyone.
ππΎ You might also like: UbuntuMed Health Insurance
ππΎ You might also like: UbuntuMed Hospital Plan
UbuntuMed Primary Care is a health insurance plan that covers day-to-day medical expenses, maternity care, screening and prevention services, and consultations with GPs, Nurses, and Specialists.
The benefits of the UbuntuMed Primary Care plan include access to preventative health services, consultations with a wide range of medical professionals, and coverage for day-to-day medical expenses and maternity care.
No, the UbuntuMed Primary Care plan does not include hospital coverage.
No, the UbuntuMed Primary Care plan does not provide benefits for MRI or CT scans.
No, the UbuntuMed Primary Care plan does not provide benefits for oncology treatments.
Eligibility for the UbuntuMed Primary Care plan may vary depending on factors such as age, location, and pre-existing medical conditions.
Yes, the UbuntuMed Primary Care plan allows for consultations with specialists as part of the cover provided.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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