Sanlam Primary Care
Affordable health insurance
Wellworx is licenced to sell a valuable new health insurance product from Sanlam – Sanlam Primary Care – that puts affordable healthcare within reach of everyone.
All from as little as R450 p/m for a main member!
Get a quote to enjoy peace of mind
Sanlam Primary Care
Affordable health insurance
Wellworx is licenced to sell a valuable new health insurance product from Sanlam – Sanlam Primary Care – that puts affordable healthcare within reach of everyone.
All from as little as R450 p/m for a main member!
Get a quote to enjoy peace of mind
What does it offer?
Sanlam Primary Standard comes with a range of day-to-day benefits, e.g. visits to GPs, dentists, optometrists and specialists, as well as benefits for radiology, pathology, and acute and chronic medication.
Benefits
GP visits (1-month waiting period)
Unlimited visits to a contracted network GP. Includes certain in-room procedures, such as wound care and stitches.
Out-of-network GP visits (1-month waiting period)
Two consultations per person per year. Refunded up to a maximum of R475 per visit.
Acute medication (1-month waiting period)
Unlimited acute medication from either a dispensing network GP or pharmacy, subject to our approved formulary.
Chronic medication (per CDL) (6-month waiting period)
Unlimited chronic medicine, restricted to diseases on the Chronic Disease List (CDL). All chronic medicine must be applied for by the prescribing medical expert.
Over-the-counter (OTC) medication (1-month waiting period)
Sublimit of R210 per policy per month as per our approved formulary. Limited to R850 per policy per year.
Basic pathology (1-month waiting period)
Unlimited as per our approved formulary. Member must be referred by a network GP. Services are directly linked and limited to our formulary.
Basic radiology (1-month waiting period)
Limited to one- and two-sided black-and-white X-rays. Member must be referred by a network GP. Services are directly linked and limited to the formulary.
Basic dentistry (6-month waiting period)
Dentist consultations and procedures are managed according to our approved protocols and limits.
Basic optometry (6-month waiting period)
Members may use the Spec-Savers network only. Includes one consultation, one frame and single vision lenses per beneficiary every 24 months, to a maximum of R1 450.
Maternity (1-month waiting period)
Limited to two growth scans per pregnancy, prenatal vitamins and required pathology tests as per our formulary.
Specialist visits (1-month waiting period)
Limited to R2 600 per beneficiary per year. Specialist benefits are available on a pay-and-claim basis. The member must be referred by a network GP.
Accidental Death Benefit
R15 000 per principal member; R10 000 per adult dependant;
R8 000 per child dependant.
Casualty Room Benefit
R2 000 per policy per year. Only available after hours and must be pre-authorised through our 24-hour emergency call centre.
Monthly premiums
Primary Standard
2024 rates
Main member
R450
Spouse
R430
Child
R160
Pharmacy clinics
Pharmacy nurse visits
Unlimited managed visits. Available at Dis-Chem and Clicks Pharmacies. Pre-authorisation is required after the 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.
Important to know
For GP and dentistry benefits, members can choose any provider in the Sanlam Primary Care network.
For optometry benefits, members can use any Spec-Savers outlet nationwide.
For hospital-related benefits, members can use any private hospital.
Scheme rules apply
Terms and Conditions apply