Unity Health Group Primary Care Plan
Overall, the Unity Health Group Primary Care Plan is a trustworthy and comprehensive medical health plan that offers 24/7 medical emergency assistance and comprehensive cover to up to 3 Family Members. The Unity Health Group Primary Care Plan starts from R339 ZAR. Unity Health has a trust rating of 2.8.
| 🔎 Medical Health Plan | 🥇 Unity Health Group Primary Care |
| 🌎 International Cover | None |
| 👤 Main Member Contribution | R339 |
| 👥 Adult Dependent Contribution | R339 |
| 😊 Child Dependent Contribution | R339 |
| 🔁 Gap Cover | None |
| 😷 Screening and Prevention | ✅ Yes |
| 💶 Medical Savings Account | None |
| 🍼 Maternity Benefits | ✅ Yes |
| 💚 Pre and Postnatal Care | Prenatal only |
Unity Health Group Primary Care Plan – 7 Key Point Quick Overview
- ✅ Unity Health Group Primary Care Plan Overview
- ✅ Unity Health Group Primary Care Plan Premiums 2023
- ✅ Unity Health Group Primary Care Plan Benefits and Cover Comprehensive Breakdown
- ✅ Unity Health Group Primary Care Plan Exclusions and Waiting Periods
- ✅ Unity Health Group Primary Care Plan vs Plans Offered by Other Providers
- ✅ Our Verdict on the Unity Health Group Primary Care Plan
- ✅ Unity Health Group Primary Care Plan Frequently Asked Questions
Unity Health Group Primary Care Plan Overview
The Unity Health Group Primary Care Plan is one of 4, starting from R339, and includes comprehensive cover for out-of-hospital treatment, services, procedures, and consultations with doctors and nurses, whether in-person or online via Intercare.
Gap Cover is not available on the Unity Health Group Primary Care Plan. However, Unity Health offers 24/7 medical emergency assistance.
Unity Health has the following four plans to choose from:
Unity Health Group Primary Care Plan Premiums 2024
Best Health Insurance that is affordable for a family :
The premiums for Unity Health’s Group Primary Care are adjustable. They are based on certain factors, such as the policyholder’s age and family structure, which determine the number of insured individuals under the policy.
It is worth noting that the premiums usually start from R339, which we found to be competitive compared to other health insurance providers in South Africa.
Consider adding GAP cover? Read more about the 10 Best Gap Covers in South Africa
Unity Health Group Primary Care Plan Benefits and Cover Comprehensive Breakdown
Unity Health Major Benefits
| 🟥 General Practitioner (GP) Consultations | Members can choose from more than 4,000 network doctors.
Consultations are unlimited when using a network doctor. |
| 🟧 GP In-Room Procedures | Included in a GP consultation.
Includes wound stitching, circumcision, applying a cast to a broken limb, etc. |
| 🟨 GP Visits – Out-of-Network | Limited to R310 per visit.
Limited to 2 out-of-network visits per insured yearly.
Member must pay upfront and then claim back from the insurer. |
| 🟩 GP Visits – Intercare Online | Unlimited online GP consults via Intercare.
Members can access this benefit using the Unity Health online portal or app. |
| 🟦 Nurse Consultations | Unlimited consultations from approved pharmacies such as Alpha Pharm, Clicks, Local Choice, Medicare, or Clicks.
Nurses may prescribe up to Schedule 2 medication. |
| 🟪 Telemedicine Consultations | Unlimited virtual GP consultations using approved pharmacies with a nurse clinic. |
| 🟥 Acute Medication | Medication can be dispensed from a network doctor.
When visiting a non-dispensing doctor, the insured will receive a prescription to collect medication at their closest network pharmacy.
Medication is subject to the Unity Health formulary. |
| 🟧 Chronic Medication | Unity Health covers 8 – 27 chronic conditions, including HIV/AIDS.
Insured members must register for the chronic medicine program.
When the member is approved, they will be contacted by MEDIPOST to arrange medication delivery. |
| 🟨 Basic and Emergency Dental Treatment | Limited to R1,375 per visit with an overall annual limit (OAL) of R4,100 per family yearly.
Treatment will include the following:
Full mouth assessment
Intraoral radiographs
Scale and polish
Tooth extractions
Emergency root canal
Fillings
Pain and sepsis treatment |
| 🟩 Optometry | Limited to one eye exam per insured person every 2 years.
Includes a standard frame worth R499 and one pair of clear, standard lenses per person every 2 years.
Members must use Specsavers or Execuspecs as the partnered provider. |
| 🟦 Basic Pathology | Includes a basic list of tests such as cholesterol or glucose.
Includes a COVID-19 PCR pathology test.
Pre-authorization and a referral are required. |
| 🟪 Basic Radiology (X-rays) | Includes black and white X-Rays.
Requires a referral from a network GP. |
| 🟥 Pre-birth Maternity Benefit | Includes 2 gynecologist consultations and 2 ultrasounds per year.
Limited to R3,800 per family yearly.
Pre-approval is mandatory.
Members can go to any gynecologist, but upfront payment must be done by the member, after which they can claim to be reimbursed. |
| 🟧 Specialist Consultations | Limited to R1,500 per visit with an OAL of R3,150 per family yearly.
Pre-approval and a GP referral are required. |
Unity Health Wellness Benefits
| ❤️ Health Screenings | Limited to one screening per insured per year at approved pharmacies and includes tests/checks of the following:
Blood pressure
Cholesterol
Glucose levels
Body Mass Index (BMI)
Waist Circumference
HIV (includes pre-and post-counseling) |
| 🧡 Pap Smears | Limited to one every three years for female members 21>.
Available at approved pharmacies. |
| 💛 PSA Screening | Available to male members once every 2 years for those 50>.
Available at approved pharmacies. |
| 💚 Vaccination Program | Includes the following:
Flu – once yearly, by 31 May
Tetanus – once every 10 years
Hepatitis A and B – once per lifetime
Pneumococcal – once every 5 years for members 60> and those with a medically proven compromised immune system. |
| 💙 Telephonic Assistance Program | Unlimited availability via telephone and Skype.
Includes the following:
Critical incidence and trauma counseling.
HIV counseling.
Legal advice and financial advice. |
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Unity Health Group Primary Care Plan Exclusions and Waiting Periods
Unity Health Group Primary Care Plan Exclusions
Outlined below are the exclusions from the cover which pertain to the services, conditions, or events not covered:
- ✅ Incidents related to nuclear weapons or nuclear material, ionizing radiation, or contamination by radioactivity from any nuclear fuel or nuclear waste arising from the combustion of nuclear fuel, which includes any self-sustaining nuclear fission process.
- ✅ Surgery or treatment for obesity or its sequel, cosmetic surgery, or surgery directly or indirectly caused by or related to cosmetic surgery, except as a result of an Insured Incident.
- ✅ Suicide, attempted suicide, or self-inflicted injuries, except if done to save another human life.
- ✅ Routine physical or purely diagnostic procedures, any other examination without objective indications of impairment in normal health, and laboratory diagnostic or x-ray examinations, except in the course of a medical condition or disability established by a prior call or attendance of a Medical Practitioner.
- ✅ All expenses are determined by the clinical review team of the Underwriting Manager.
- ✅ Expenses that are not medically necessary or clinically appropriate or do not meet the Insured Person’s healthcare needs, are inconsistent in type, frequency, and duration of treatment.
- ✅ Procedures performed in doctors’ offices are not described in the tariff code list.
- ✅ Any accident that occurred before the Insured Person’s policy start date.
- ✅ The use of any drug or narcotic, except when prescribed by and used per the instructions of a registered Medical Practitioner other than the Insured Person, or any illness caused by alcohol use.
and many more. A full list of exclusions will be supplied by Unity Health.
Unity Health Group Primary Care Plan Waiting Periods
The waiting periods for Unity Health insurance policies vary and depend on the cover type and policy. Please see below for the standard Unity Health waiting periods:
- ✅ General medical services, such as doctor visits, prescription drugs, and diagnostic tests, usually require a waiting period of three months.
- ✅ Specialist consultations and procedures usually have a waiting period of six months.
- ✅ For maternity benefits, including prenatal care, delivery, and postnatal care, the standard waiting period is typically 12 months.
A waiting period of 12 months is typically required for pre-existing conditions.
Unity Health Group Primary Care Plan vs Plans Offered by Other Providers
| 🔎 Medical Health Plan | 🥇 Unity Health Group Primary Care | 🥈 Dis-Chem Health MyHealth Core | 🥉 Bonitas BonCap Plan |
| 🌎 International Cover | None | None | R10 million |
| 👤 Main Member Contribution | R339 | R469 – R591 | R1,430 |
| 👥 Adult Dependent Contribution | R339 | R469 – R591 | R1,430 |
| 😊 Child Dependent Contribution | R339 | R329 – R382 | R673 |
| 🔁 Gap Cover | None | ✅ Yes | ✅ Yes |
| 😷 Screening and Prevention | ✅ Yes | ✅ Yes | ✅ Yes |
| 💶 Medical Savings Account | None | None | None |
| 🍼 Maternity Benefits | ✅ Yes | ✅ Yes | ✅ Yes |
| 💚 Pre and Postnatal Care | Prenatal only | None | ✅ Yes |
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Our Verdict on the Unity Health Group Primary Care Plan
Overall, we found that the Unity Health Group Primary Care Plan offers unlimited GP consultations within their network of over 4,000 doctors across South Africa, making it a convenient and accessible option for those seeking general health and well-being care.
The added benefit of Intercare Consultations through their online portal or app provides an alternative option for remote consultations. However, prospective members must consider the plan’s drawbacks, which include no cover for hospitalization or accident-related medical care, no specialized dentistry, and limited medical cover for individuals with serious health problems.
We can conclude that the plan is suitable for those looking for basic health coverage. However, those with specific health needs should evaluate their options thoroughly.
Unity Health Group Primary Care Plan Frequently Asked Questions
What is included in the Unity Health Primary Care Plan?
The Unity Health Primary Care Plan includes unlimited GP consultations within their network, access to Intercare consultations, and other general health and wellbeing services.
Does the Unity Health Primary Care Plan cover hospitalization or accident-related medical care?
No, the Unity Health Primary Care Plan does not cover hospitalization or accident-related medical care.
Does the Unity Health Primary Care Plan cover specialized dentistry?
No, the Unity Health Primary Care Plan does not cover specialized dentistry.
Who is the Unity Health Primary Care Plan suitable for?
The Unity Health Primary Care Plan may suit individuals seeking general health and well-being care.
How can I find a Unity Health Group Primary Care location near me?
You can find a Unity Health Group Primary Care location near you by visiting their website and location finder tool. You can also call their customer service line for assistance.
Who are the providers at Unity Health Group Primary Care?
Unity Health Group Primary Care has a team of experienced and compassionate providers, including family medicine physicians, nurse practitioners, and physician assistants.
Does the Unity Health Primary Care Plan provide extensive medical coverage for individuals with serious health problems?
No, the Unity Health Primary Care Plan does not provide extensive medical cover for individuals with serious health problems.
What is the Unity Health Group Primary Care patient portal?
The Unity Health Group Primary Care patient portal is a secure online platform that allows patients to access their medical records, request prescription refills, communicate with their providers, and schedule appointments. Patients can access the portal through the Unity Health Group website.
