Unity Health Individual Primary Care Plan ( 🇿🇦 2025*)

 

Overall, the Unity Health Individual Primary Care Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and optometry benefits for its Family Members. The Unity Health Individual Primary Care Plan starts from R435 ZAR.  Unity Health has a trust score of 2.8.

 

🔎 Medical Health Plan	🥇 Unity Health Individual Primary Care
🌎 International Cover	None
👤 Main Member Contribution	R435
👥 Adult Dependent Contribution	R345
😊 Child Dependent Contribution	R139
🔁 Gap Cover	None
😷 Screening and Prevention	✅ Yes
💷 Medical Savings Account	None
💙 Chronic Conditions	✅ Yes
🏡 Home Care	None

 

Unity Health Individual Primary Care Plan – 7 Key Point Quick Overview

 

1. ✅ Unity Health Individual Primary Care Plan Overview
2. ✅ Unity Health Individual Primary Care Plan Premiums 2025
3. ✅ Unity Health Individual Primary Care Plan Benefits and Cover Comprehensive Breakdown
4. ✅ Unity Health Individual Primary Care Plan Exclusions and Waiting Periods
5. ✅ Unity Health Individual Primary Care Plan vs Plans Offered by Other Providers
6. ✅ Our Verdict on the Unity Health Individual Primary Care Plan
7. ✅ Unity Health Individual Primary Care Plan Frequently Asked Questions

 

Unity Health Individual Primary Care Plan Overview

 

💙 The Unity Health Individual Primary Care Plan is one of 4, starting from R435, and includes cover for in and out-of-network GP visits, medication, 8 listed chronic conditions, basic and emergency dental treatment, optometry, and more.

 

💙 Gap Cover is not available on the Unity Health Individual Primary Care Plan. However, Unity Health offers 24/7 medical emergency assistance. According to the Trust Index, Unity Health has a trust rating of 2.8.

 

💙 Unity Health has the following four plans to choose from:

 

• ✅ Unity Health Group Hospital Plan
• ✅ Unity Health Group Primary Care
• ✅ Unity Health Individual Hospital Plan
• ✅ Unity Health Individual Primary Care

 

 

Unity Health Individual Primary Care Plan Premiums 2025

 

💙 The premiums for Unity Health’s Individual 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 R435, which we found to be competitive compared to other health insurance providers in South Africa.

 

👉🏾 You might consider adding GAP Cover, discover the 5 Best Gap Cover Options for Under R1 000

 

 

Unity Health Individual Primary Care Plan Benefits and Cover Comprehensive Breakdown

 

Unity Health Major Benefits

 

🟥 General Practitioner (GP) Consultations	Members can choose from more than 4,100 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 R330 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 eight listed 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 R1,500 per visit with an overall annual limit (OAL) of R4,500 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 R599 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 R4,000 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 R1,600 per visit with an OAL of R3,350 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.
🟩 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.

 

👉🏾 Discover more about medical aid

 

 

Unity Health Individual Primary Care Plan Exclusions and Waiting Periods

 

Unity Health Individual Primary Care Plan Exclusions

 

💙 Outlined below are the exclusions from the cover that 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.

 

Unity Health Individual 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.

 

👉🏾 Read more about the 5 Best Hospital Plans for Domestic Workers

 

 

Unity Health Individual Primary Care Plan vs Plans Offered by Other Providers

 

🔎 Medical Health Plan	🥇 Unity Health Individual Primary Care	🥈 Bloom Health4Me Bronze	🥉 Fedhealth FlexiFED Savvy
🌎 International Cover	None	None	None
👤 Main Member Contribution	R435	R655 – R1,049	R1055
👥 Adult Dependent Contribution	R345	R655 – R1,049	R1055
😊 Child Dependent Contribution	R139	R391 – R588	R775
🔁 Gap Cover	None	None	None
😷 Screening and Prevention	✅ Yes	✅ Yes	✅ Yes
💷 Medical Savings Account	None	None	✅ Yes
💙 Chronic Conditions	✅ Yes	None	✅ Yes
🏡 Home Care	None	None	None

 

👉🏾 POLL: 5 Best Medical Aids under R500

 

 

Our Verdict on the Unity Health Individual Primary Care Plan

 

💙 Based on our personal experience, we found that the Unity Health Individual Primary Care Plan provides basic health coverage at an affordable price. This plan gives its members access to general practitioners, basic dentistry, and limited coverage for chronic conditions.

 

💙 However, we did encounter several drawbacks, including the exclusion of scopes and scans, no cover for contact lenses, and no in-hospital cover. Additionally, we found that the plan has limited cover overall.

 

💙 Therefore, while it is ideal for South Africans who are healthy and who do not have any medical issues, it might not be the best option for everyone.

 

• 👉🏾 You might also like: Unity Health Group Hospital Plan
• 👉🏾 You might also like: Unity Health Group Primary Care
• 👉🏾 You might also like: Unity Health Individual Hospital Plan
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Unity Health Individual Primary Care Plan Frequently Asked Questions

 

What is Unity Health Individual Primary Care Plan?

Unity Health Individual Primary Care Plan is a comprehensive primary care plan designed to provide affordable and accessible healthcare services to individuals. The plan includes preventive care, chronic disease management, and access to a network of healthcare providers.

 

What are the benefits of Unity Health Individual Primary Care Plan?

Some of the benefits of Unity Health Individual Primary Care Plan include low copays, no deductibles, telemedicine services, and comprehensive cover for preventive care, chronic disease management, and urgent care.

 

How much does Unity Health Individual Primary Care Plan cost?

Unity Health Individual Primary Care starts from R410 and will depend on how many beneficiaries/dependents you add to the policy.

 

Does Unity Health Individual Primary Care Plan cover pre-existing conditions?

Yes, Unity Health Individual Primary Care Plan covers pre-existing conditions, including chronic diseases, as long as they are disclosed during enrollment. However, certain waiting periods might apply. Therefore, we recommend that you confirm with Unity Health before enrolling.

 

What is the provider network for Unity Health Individual Primary Care Plan?

Unity Health Individual Primary Care Plan has a network of healthcare providers that includes primary care physicians, specialists, and hospitals. You can search for a provider in your area by visiting the Unity Health website.

 

Does Unity Health Individual Primary Care Plan include dental and vision cover?

Yes, Unity Health offers basic optometry and dental treatment on the Individual Primary Care Plan.

 

How do I enroll in Unity Health Individual Primary Care Plan?

You can enroll in Unity Health Individual Primary Care Plan by visiting their website or contacting customer service. We found the registration process straightforward and the Unity Health agents extremely informative and responsive to queries.

 

Can I cancel my Unity Health Individual Primary Care Plan at any time?

Yes, you can cancel your Unity Health Individual Primary Care Plan anytime. However, you may be subject to a penalty or lose cover if you cancel before the end of the policy period. However, you must review the terms and conditions of your plan before canceling.