Essential Med is a health insurance provider that offers various primary healthcare, hospital, and additional benefits. Customers can build their own insurance plan by selecting from different benefit levels that offer varying levels of coverage for things like doctor visits, medication, hospital stays, specialists, and more. Essential Med uses a network of providers and offers benefits for medical expenses, maternity care, dread diseases, accidents, and funeral costs.

1. Essential Med Version 1 2016. Dated November 2016.
...life uninterrupted
Brochure 2016
0861 70 70 70
www.essentialmed.co.za
Essential Med is a registered Financial Services Provider. FSP No: 42980.

2. AS YOU CHOOSE TO
HEALTH INSURANCE
With our unique quoting engine you build your own plan –
around your individual needs
Scheduled and
emergency
doctors visits
Cover options for
acute and chronic
medication
Visits to a
network of
specialists
Access to dentistry
and optometry
benefits
Radiology and
pathology cover
options
Illness and
maternity cover
Accidents ICU Permanent
disability
Dread disease
Hospital Cover Benefits Include:
Primary Health Cover Benefits Include:
Essential Med Version 1 2016. Dated November 2016.
Casualty
Please note this is a Health Insurance Product and not a Medical Aid.

3. SPECIALIST VISITS
Essential Med Version 1 2016. Dated November 2016.
Included As Standard Benefit
Should your doctor require you to have
blood tests or X-rays done, an extensive
list of covered items is available. 30 day
waiting period applies.
RADIOLOGY &
PATHOLOGY
ACUTE & CHRONIC
MEDICATION
PRIMARY HEALTH COVER
Unlimited Acc To Formulary Including Over
The Counter Meds.
Acute Medication: Formulary - an
extensive list of acute medication is
available to you.
The Essential Med Acute Medication
Formulary is applicable. 30 day waiting
period applies to acute & 6 month waiting
period applies to chronic.
DENTISTRY
Managed unlimited dentist consultations and procedures as per formulary, including cleaning, pain control,
amalgam fillings and normal extractions. These services are obtained from an Essential Med network registered
provider. 6 month waiting period applies.
Managed unlimited dentist
consultations and procedures as
per formulary, including cleaning,
pain control, amalgam fillings and
normal extractions. These
services are obtained from an
Essential Med network registered
provider.
1 Root Canal Treatment to the
value of R2000 per event per
beneficiary within a 12 month
period. 1 Crown per beneficiary to
the value of R4500 per event
within a 24 month period. Resin
Fillings included. These services
are obtained from an Essential
Med network registered provider.
2 Root Canal Treatments to the value
of R2000 per event per beneficiary
within a 12 month period. 2 Crowns
per beneficiary to the value of R4500
per event within a 24 month period.
Resin Fillings included. These
services are obtained from an
Essential Med network registered
provider. Includes a R2000 annual
overall limit to be applied in event of
shortfall.
Benefit Level 1 Benefit Level 2 Benefit Level 3
If your doctor requires you to be seen by a Specialist, an annual benefit
amount is available to help cover these costs. 90 day waiting period
applies.
R1500 Benefit Per Poli-
cy Per Annum
R2000 Benefit Per
Policy Per Annum
R1000 Benefit Per
Policy Per Annum
Benefit Level 1 Benefit Level 2 Benefit Level 3
UNLIMITED GP CONSULTATIONS
When making use of one of our many GP Network Providers, you will have access
to unlimited primary healthcare benefits. In the event of making use of a Non
Network Provider, you will be reimbursed up to R250 for the consultation.

4. FUNERAL BENEFITS
VALUE ADDED BENEFITS - ESSENCE
OPTOMETRY
Your Optometry benefit includes an eye test per beneficiary. 12 month waiting period applies.
Can be added to any combination plan. A Funeral Benefit will be paid out within 48 hours upon receipt of all required
documentation. A 3 month waiting period is applicable to death due to natural causes. No waiting period in the
event of death due to accident. Rules for dependents.
Be part of our Essence Reward Program and you'll get rewarded for all kinds of "good behaviour" like paying your
premium on time, responsible use of benefits, introducing your friends and much more! Essence is super simple to
understand and manage - no Ph.D. required!
Essential Med Version 1 2016. Dated November 2016.
Benefit Level 1 Benefit Level 2 Benefit Level 3
Free single vision lenses and
frames every 24 months.
Free single or bi-focal vision
lenses and frames every 24
months.
Free single or bi-focal vision
lenses and frames every 24
months. This option also
includes contact lenses - 4
packages in a 24-month cycle
to the value of R350.
Benefit Level 1 Benefit Level 2 Benefit Level 3
Funeral Benefit of R10 000 Funeral Benefit of R20 000 Funeral Benefit of R30 000

5. HOSPITAL COVER
ACCIDENT
HOSPITALISATION
ILLNESS
HOSPITALISATION
Accidents happen and we understand that. No waiting periods are applicable to
events that are related to accidents. Emergency Medical Services are automatically
included. AOL = Annual Overall Limit.
No one plans to get ill and have to be admitted to hospital. In the event of you or
your family members requiring admission, the below amounts are available for
hospitalisation:
Included in Benefit Level 3: Stated Conditions amounts paid regardless of
admission days, but not in addition to the Daily Illness Benefit. Certain procedures
no longer require extended periods of admission, for this reason we have cover for
specific events.
 Hernia - R20 000
 Appendectomy - R35 000
 Gall / Kidney - R35 000
 Miscarriage - R10 000
A 12 month waiting period is applicable to the stated condition benefits.
 Hysterectomy - R45 000
A 24 month waiting period is applicable.
Essential Med Version 1 2016. Dated November 2016.
Benefit Level 1 Benefit Level 2 Benefit Level 3
1st 24 hrs: Up to R6 500
Day 2: Up to R4 500
Day 3: Up to R4 500
Day 4 onwards:
Up to R1 500. Maximum
21 days’ total
admission. Subject to a
3 month waiting period.
1st 24 hrs: Up to R10 000
Day 2: Up to R6 500
Day 3: Up to R5 000
Day 4 onwards:
Up to R1 500. Maximum
21 days’ total admission.
Subject to a 3 month
waiting period.
1st 24 hrs: Up to R10 000
Day 2: Up to R6 500
Day 3: Up to R5 000
Day 4 onwards:
Up to R1 500. Maximum
21 days’ total admission.
Subject to a 3 month
waiting period.
This benefit is available in addition to Illness benefit.MATERNITY
HOSPITALISATION In the event your Doctor advising that a C-Section is necessary in order to
deliver your baby, there is a R35 000 benefit available for this admission.
Should you have a normal delivery, R25 000 is available for this event. Subject
to a 12 month waiting period. 1 event per 12 months.
Please note this is a Health Insurance Product and not a Medical Aid.
Benefit Level
1
Benefit Level
2
Up to
R250 000 per
incident per
family with an
AOL of
R500 000.
Up to
R150 000 per
incident per
family with an
AOL of
R300 000.
Up to
R400 000 per
incident per
family with an
AOL of
R800 000.
Up to
R600 000 per
incident per
family with an
AOL of
R1 200 000.
Up to
R1 000 000 per
incident per
family with an
AOL of
R2 000 000.
Benefit Level
3
Benefit Level
4
Benefit Level
5

6. DREAD DISEASE
PERMANENT
DISABILITY
In the event of your Illness or accident requiring you to be admitted to ICU or High
Care, a Daily Benefit amount will be available to cover these costs. 3 month waiting
period if due to illness. Maximum 5 days allowed.
Heart Attacks, Coronary Heart Disease, Stroke, Cancer and Kidney Failure are a
few of the conditions that are covered in this Benefit. 6 month waiting period
applies.
Should an accident occur that results in permanent disability, for example a loss of
a limb, a Permanent Disability Benefit amount will be paid out less costs already
paid.
For those after hour emergencies that are never planned for and don’t require
admission, we offer generous cover to help pay for costs at Casualty. 30 day
waiting period if due to illness.
CASUALTY WARD
BENEFIT
ICU CARE
Essential Med Version 1 2016. Dated November 2016.
Benefit Level 1 Benefit Level 2
ICU or High Care, a Daily Benefit
amount of R12 500 will be available
to cover these costs.
ICU or High Care, a Daily Benefit amount
of R20 000 will be available to cover
these costs.
Benefit Level 1 Benefit Level 2 Benefit Level 3
R9 000 a day while
admitted for a confirmed
Dread Disease and up to
the maximum benefit limit
of R185 000 will be paid
out according to the
staging of the disease.
R9 000 a day while
admitted for a confirmed
Dread Disease and up to
the maximum benefit
limit of R250 000 will be
paid out according to the
staging of the disease.
R9 000 a day while
admitted for a confirmed
Dread Disease and up to
the maximum benefit limit
of R350 000 will be paid
out according to the
staging of the disease.
Benefit Level 1 Benefit Level 2 Benefit Level 3
Up to R200 000 will be
paid out less costs
already paid. Main
member only.
No waiting periods
applied.
Up to R250 000 will be
paid out less costs
already paid. Main
member only.
No waiting periods
applied.
Up to R250 000 will be
paid out less costs already
paid. This applies to both
main member and
spouse. No waiting
periods applied to princi-
pal member - 6 months
applied to spouse.
Benefit Level 1 Benefit Level 2 Benefit Level 3
Up to R2000 in total per
annum.
Up to R4000 in total per
annum.
Up to R6000 in total per
annum.

7. ESS MED MEDICAL COVER (Pty) Ltd
Trading as Essential Med
Registration number: 2011/116999/07
Essential Med is a registered financial services provider. FSP 42980.
Hospital cover underwritten by African Unity Life. FSP 8447. Reg No: 2003/016142/06.
Essential Group Building, Olive Grove Estate, Ou Paardevlei Road, Somerset West, 7130
PO Box 653, Somerset Mall, 7137,
Tel: 0861 70 70 70, Fax: 0865 327 661, Email: info@essentialmed.co.za,
Website: www.essentialmed.co.za
/essentialmed /essentialmedSA
Essential Med Version 1 2016. Dated November 2016.