With around 85% of South Africans currently relying on public hospitals and clinics, many of which are over-extended, it has become clear that lower-income earners in the country need access to quality private healthcare.

Enter primary healthcare plans, which meet essential healthcare needs in an innovative, cost-effective way. These tiered insurance products – distinct from medical aids as they don’t cater for Prescribed Minimum Benefits and do not offer comprehensive benefits – offer a range of day-to-day benefits, such as doctor visits and medication and some also offer private hospitalisation within their benefit structures.

Old Mutual enters the primary healthcare space

As part of Old Mutual Corporate’s Employee Benefits offering, Old Mutual Health Solutions covers Primary Care, Gap Cover, and related Ancillary products. This comprehensive range aims to provide high-quality healthcare solutions to employees and members via their employers and work-related groups. Available as Old Mutual Health Solutions’ health insurance and gap cover, these offerings are underwritten and administered by GENRIC, a licensed non-life insurer within the Old Mutual group of companies.

GENRIC is a leading provider of both “off-the-shelf” and tailor-made solutions to corporate employers who are looking to provide both primary and tertiary healthcare benefits for their employees. As such, GENRIC plays a vital role in ensuring that low-income earners have improved access to quality private healthcare.  

Many workers are forced to miss days of work seeking medical attention and may not get the quality care they need to recover completely from illness or injury, so employers have a vested interest in the success of such products.

Old Mutual Health Solutions may be attractive to employers as it offers a range of unique benefits at affordable prices. Its national network brings 3 483 GPs, 3 420 pharmacies, 2 243 dentists, 741 pathology laboratories, 736 private hospitals, 581 radiologists, 450 optometrists and 357 specialists within reach of members.

Product Options

Employees who earn up to R30 000 a month will qualify for this health-insurance offering.

The entry-level option, Golden Hour Plus, provides two GP consultations at a contracted network doctor, up to R1-million in in-hospital accident benefits per policy, up to R500 000 in in-hospital illness benefits per policy, unlimited 24/7 private emergency services and R1 500 of acute medications in a year, among other benefits.

The cost for the main insured is only R260 a month, with R280 levied for an adult dependant and R155 for a child. 

The next option, Comprehensive Standard, offers managed unlimited GP consultations, up to R750 000 in-hospital accident benefits per policy, up to R500 000 in in-hospital illness benefits per policy, unlimited acute and chronic medications and unlimited 24/7 private emergency services, among other benefits.

This costs R400 for the main insured, R480 for an adult dependant and R215 for a child dependant.

Lastly, Primary Standard Plus provides managed unlimited GP consultations, up to R1 million in in-hospital accident benefits per policy, up to R1 million in in-hospital illness benefits per policy, unlimited acute and chronic medications and unlimited 24/7 private emergency services, among other benefits.

The top-tier product costs R440 a month for the main insured, R535 for an adult dependant and R235 for a child.

It is worth noting that premiums may be adjusted every year.

Not a replacement for medical aid

The product isn’t a replacement for medical aid, and employers who can afford medical aid should continue with it.

Employers who are unable to offer medical aid to their employees should consider this best-in-class primary-care solution.

The product has stand-out features that provide excellent value for money, such as an illness and accident in-hospital benefit, emergency benefits and 24-hour transportation to private hospitals.

Old Mutual Life Assurance Company (SA) Limited is a licensed FSP and Life Insurer. This product is underwritten and administered by GENRIC Insurance Company Limited, a licensed non-life insurer and an authorised Financial Service Provider (FSP: 43638). National Health Group (Pty) Ltd (2015/130345/07), a registered Managed Care Organisation (MCO110) and Administrator (ADMIN72), is contracted to provide administration and managed care services. This is not a medical scheme, and the cover is not the same as that of a medical scheme. This Policy is not a substitute for a medical scheme membership. Premiums are subject to an annual review. Terms and Conditions apply.

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