Herminix Health4All

A basket of benefits exclusively available to registered members.

Health4All is not a Medical Aid and does not replace any Medical Aid benefits.

Health4All is a Health Assist Membership Program.

Health4All products

primary care

-- From R 550 pm --

hospital care

-- From R 320 pm --

primary & hospital care

-- From R 770 pm --

benefit comparison

Unlimited GP consultations

At any Unity Health Network GP. Pre-authorization required for 10 or more GP or Nurse visits per person per annum. We have over 3,500 Unity Health network doctors nationwide. For your nearest network doctor call our Call Centre on 086 136 6006 or search for a network doctor on your Unity Health App or on our website by logging into your member portal.

GP Procedures

Minor procedures in doctors’ rooms are included in GP visits e.g., wound stitching, applying a cast to a broken arm, circumcision, etc.

Unlimited Nurse consultations

Nurse consultations available at approved pharmacies (Clicks, Dischem & Pick n Pay) for minor ailments. In many practices, nurses can provide scripts for minor ailments for up to schedule 2 medications.

Pre-authorization required for 10 or more GP or Nurse visits per person per annum. consequatur.

Specialist consultations

Limited to R1 350 per visit with an overall limit of R2 800 per family per year. Referral by Unity Health Network GP and pre-authorization required.

Acute medications

Dispensing GP: This means your GP dispenses medication and will provide you with the necessary medication.

Non-Dispensing GP: Unlimited

Limited to medication prescribed during your Network GP visits.

This means your Network GP does not provide you with medication but will provide you with a prescription to collect your medication.

Available at approved pharmacies (Clicks, Dischem & Pick n Pay).

Chronic medications

Chronic Medication Programme: 27 Listed “high impact” Conditions2 HIV/AIDS included. Chronic condition: A condition / disease that lasts for an extended period of time.

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 Mediscor’s website: www.mediscor.co.za. Approved pharmacies include Clicks, Dischem, Pick n Pay & Medicross.

Asthma; Chronic Obstructive Pulmonary Disorder; Diabetes Type 1&2; Epilepsy; HIV/AIDS; Hyperlipidemia; Hypertension; Tuberculosis; Addison’s Disease; Bi-polar Mood Disorder; Bronchiectasis; Cardiac Failure; Cardiomyopathy Disease; Chronic Renal Disease; Coronary Artery Disease; Crohn’s Disease; Diabetes Insipidus; Dysrhythmias; Glaucoma; Hemophilia; Hypothyroidism; Multiple Sclerosis; Parkinson’s Disease; Rheumatoid Arthritis; Schizophrenia; Systemic Lupus Erythematosus; Ulcerative Colitis.

Basic & emergency dental treatment

Limited to R1 350 per person per incident

Treatment includes full mouth assessment, intra oral radiographs, scale & polish, extractions, emergency root canal treatment, fillings, pain and sepsis treatment.

Only available at Unity Health Dentists. Specialized dentistry/treatment, such as bridgework or crowns; orthodontic treatment; and dentures are not covered.

Optometry

One eye test per person per year.

A standard frame to the value of R254 and one pair of clear standard spectacle lenses per person per 24 months. Available at PPN Network Optometrists.

Pathology

Basic list of blood tests at a Designated Service Provider.

Your Network GP must ask for these tests to be done. E.g., blood sugar or cholesterol tests

Radiology

Black & white X-rays only at a Designated Service Provider. Your Network GP has to refer you to have X- rays done. Specialized radiology such as MRI / CT scans is not covered.

Maternity

2 gynecologists visits, 2 ultrasound scans per year. Limited to R3 425 per family per annum. Pre-authorization is required.

1-month general waiting period, no pre-existing condition exclusions

Pap smear

Available once every 3 years after the age of 21 at Approved pharmacies (Clicks, Dischem & Pick n Pay). Your Network GP may offer Pap Smears.

Vaccination program

Influenza: Available annually – needs to be administered by 31 May each year. Tetanus: Available once every 10 years. Hepatitis A & B: Available once-off.

Pneumococcal: Available once every 5 years for those aged 60 or older and for those individuals with medically proven compromised immune system.

Available at Approved pharmacies (Clicks, Dischem & Pick n Pay)

No overall limit

No Overall Annual Limit

In-patient hospital treatment accident

The actual cost of hospitalization 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. “What is an accident?

An accident means bodily injury caused by violent accidental and external physical means. E.g. Severe injuries resulting from a vehicle accident or working with factory machinery.”

Limited to R1 250 000 per person per incident. Pre-authorization is required.

In-patient hospital stabilisation emergency

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

Medical procedures are excluded.

“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/stroke.”

Limited to R26 500 per person per incident. Pre-authorization is required.

An accident means bodily injury caused by violent accidental and external physical means. E.g. Severe injuries resulting from a vehicle accident or working with factory machinery.”

Limited to R1 250 000 per person per incident. Pre-authorization is required.

Out-patient casualty treatment accident

The benefit payable for injuries sustained,enro as a result of a minor accident shall be limited to treatment received in a hospital emergency unit. Pre-authorization is required.

Limited to R6 850 per person per incident. Pre-authorization is required.

MRI & CT scans for accident

The actual cost of a MRI or CT scan, necessitated as a result of an injury sustained due to an accident. Limited to R18 000 per person per year. Pre-authorization is required

Physiotherapy & occupational therapy

Physiotherapy & Occupational therapy following an in-patient hospitalization due to an accident.

Limited to a period of 3 months following the discharge from an in-patient hospitalization incident and limited to R3 425 per person per year. Pre-authorization is required.

Accidental death benefit

Limited to R25 000 per principal insured and first spouse dependent and R5,000 per child dependent.

Emergency services

Emergency Evacuation, including ambulance services (air or road) Inter- hospital transfers

Repatriation of mortal remains

Telephonic Medical advice (Ask a Doctor, ask a Nurse)

Unity Health push to call emergency dialing and find a provider app

primary care

hospital care

primary & hospital care

in-life benefits included with any Health4All plan

Get ALL these benefits with the plan that suites your lifestyle.

eCoupons

Legal Assist line

Credit Investigation Services

Repatriation of Mortal Remains

Emergency Medical Services

Trauma & Bereavement Line

HIV Prevention Program

Medical Advisory Service Line

Regenerative Medicine, Stem Cell & Cell-based Treatment

Compare the prices

Main member age 18 - 65

Main Member

Spouse / Adult dependent under 65

Spouse / Adult dependent over 65

Child dependent under 21

Main member age 65 - 84

Main Member

Spouse / Adult dependent under 65

Spouse / Adult dependent over 65

Child dependent under 21

Primary Care Plan

R 550 / m

R 440 / m

R 490 / m

R 220 / m

R 690 / m

R 440 / m

R 490 / m

R 220 / m

Hospital Care Plan

R 320 / m

R 190 / m

R 290 / m

R 100 / m

R 340 / m

R 190 / m

R 290 / m

R 100 / m

Primary & Hospital Care

R 770 / m

R 550 / m

R 750 / m

R 250 / m

R 840 / m

R 550 / m

R 750 / m

R 250 / m

Special Notes

  • Make sure of the option you choose.

  • There is a R 200 non-refundable joining Fee

  • The first month is a registration month where not all the benefits will be active.

  • Only 1 month waiting period.

  • GP visits requires telephonic pre-authorisation.

Frequently Asked Questions

Contact the Unity Health call centre on 0861 366 006 for a list of providers close to where the member lives or works. Make an appointment with the provider and ensure the member presents their Unity Health membership card and ID when they arrive for the consultation. You may also search for a provider using the Unity Health app or the member can log into their member portal and search for a provider online.

The Unity Health call centre is open during the following times:

• Monday to Friday: 08:00 to 17:00 and • Saturdays: 08:00 to 13:00

• In the case of emergencies after hours call ER24 on 087 135 1248.

Call the Unity Health call centre on 0861 366 006 and ask for a provider request form. Fill out the form with the member’s GP details and email to Unity Health at networks@unityhealth.co.za. Unity Health will contact the member’s GP and advise the member whether the GP decided to join or not.

The member has access to the Unity Health website portal. The member has to go onto www.unityhealth.co.za and register to gain access to search for a provider close to them via the Unity Health unique GEO mapping tool. The member can also contact Unity Health on 0861 366 006 or email at networks@unityhealth.co.za. Unity Health will forward the member a list of providers closest to them.

Unity Health provides their members with the options to download a mobile app. The Unity Health app offers useful features such as:

1. An emergency button for easy emergency assist;

2. Tracking the member’s GP visits, medication, and other claims;

3. Finding the member’s closest GP, Dentists or Optometrist;

4. The member’s digital membership card with their membership details;

5. A useful summary of the member’s plan details, benefits and limits;

6. The member’s personal details;

7. Contact details for any enquiries;

The dispensing provider will provide the member’s medication during their consultation and they will not need a script to go to the pharmacy. A non-dispensing provider will provide the member a script during their consultation and they will need to go to a Mediscor pharmacy to collect their medication.
The member should contact the Unity Health call centre on 0861 366 006 and select the option for pre-authorisations. The benefit needs to be pre-authorised by Unity Health before the member can access the benefit.
In most cases the member simply presents their Unity Health membership card and ID to the provider and the provider will submit the claim directly to Unity Health for processing and payment. In isolated cases, if the member did pay the provider directly, they may fill out a reimbursement form and email Unity Health at claims@unityhealth.co.za with all supporting documentation within 6 months from the date of treatment. Unity Health will assess and reimburse the member in respect of all valid claims.
An “emergency” is an event of a sudden, and at the time, unexpected onset of a health condition that requires immediate medical or surgical treatment, where failure to provide medical or surgical treatment would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or would place the person’s life in jeopardy. Examples include heart attacks, strokes.
  1. Call Unity Health call centre on 0861 366 006 or ER24 on 087 135 1248.
  2. ER24 will verify the membership of the person in need of help, whether it be the main member or a dependant.
  3. ER24 will assist the member with advice, and emergency transportation to their nearest in-patient hospital facility.
  4. ER24 will issue the hospital with a guarantee of payment and the member will be admitted for treatment.
  5. Unity Health will then settle the account directly with the hospital, subject to the benefit limitations

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