Talk to us
If you have any questions about Sanlam Primary Care and how it’ll benefit you and your family, please feel free to contact us directly.
Health Solutions
Sanlam Primary Care
With Sanlam Primary Care, we put affordable healthcare within everyone’s reach. So, you can be confident that you and your family will receive suitable medical care when in need.
core benefits
Comprehensive health and wellness benefits
Sanlam Health offers holistic health and wellness benefits to help our clients live with confidence.
Sanlam Primary Standard includes the following core benefits:
- Core benefits
1-month waiting period
GP visits
Unlimited visits at a contracted network provider. Includes certain in-room procedures, such as wound care and stitches.
1-month waiting period
Out-of-network GP visit
Two consultations per person per year. Refunded up to a maximum of R475 per visit.
1-month waiting period
Acute medication
Unlimited acute medication from either a dispensing network GP or pharmacy, subject to our approved formulary.
6-month waiting period
Chronic medication (per CDL)
Unlimited chronic medicine, restricted to diseases on the Chronic Disease List (CDL). All chronic medicine must be applied for by the prescribing medical expert.
1-month waiting period
Basic pathology
Unlimited as per our approved formulary. Member must be referred by a network GP. Services are linked and limited to our formulary.
1-month waiting period
Over-the-counter medication
Sub-limit of R210 per policy per month, as per our approved formulary. Limited to R850 per policy per year.
Pharmacy clinics
As part of the Sanlam Primary Standard policy, the following benefits are automatically available to members too.
- Pharmacy nurse visits
Unlimited managed visits to Dis-Chem and Clicks Pharmacies. Pre-authorisation is required after 10th visit.
- Flu vaccine
One vaccination per member per year at an approved pharmacy clinic, including Dis-Chem, Clicks and Medirite.
- HIV status and wellness
Voluntary counselling and testing through our partner pharmacies.
- Member wellness
Blood pressure, BMI, glucose and cholesterol testing at pharmacy clinics.
- Women’s health
Pap smears, breast examinations and pregnancy tests at pharmacy clinics.
- Management of chronic conditions
Available at participating pharmacy clinics
Diabetes – HbA1c and foot screening
Hypertension and cholesterol – blood pressure and lipogram testing
Asthma – peak flow measurement
- Additional
Available at participating pharmacy clinics
Haemoglobin, malaria and urine screenings
Syringing of ears, treatment of wounds and administering of injections
Add-on benefits
Accident and Emergency benefit
Members can add our Accident and Emergency benefit to their Primary Standard plan. This benefit is applicable to accidents only. If a member does not require admission to the hospital for accident-related incidents, R30,000 will be available for treatment in casualty.
If the event does not qualify as an emergency, the member will be transported to a state facility for treatment with a R15,000 stabilisation benefit included. Emergency services are only included when Accident and Emergency is selected.
In-hospital treatment
For hospital-related benefits, members can visit any private hospital. For an accident resulting in hospitalisation, compensation is as follows:
A maximum of R1 million per year with R225,000 per event, all costs included
R10 000 post-discharge benefits for follow-up treatments accumulate to the initial event sublimit
Please note these restrictions
Members must be 18 years or older
Only one adult dependant is allowed. Additional dependants must be under the age of 21.
Dependants are subject to waiting periods if they aren’t added to the policy when the policyholder joins
Full-time students may be covered on their parents’ policy, up until the age of 26