Affordable Medical Cover For Students From Only R625 Per Month in 2026

Annual Flexi Benefit (AFB)

R4 056 per beneficiary per year

R6 036 per family per year 

• Specialist consultations – Subject to referral from a Universal Care Network GP. Limited to 2 visits per beneficiary and 3 visits PMF per year. Subject to the AFB. Once benefit is depleted, PMB rules apply.
• Basic dentistry – limited to one consultation per beneficiary including preventative care, infection control, fillings, extractions and dental X-rays at a Universal Network dentist – R2 080 per beneficiary up to R3 580 per family, subject to the AFB
• Optometry – limited to one test per beneficiary every 24 months. Benefit for glasses with frame or contact lenses every 24 months. Clear plastic lenses for single vision or contact lenses and frames limited to R1 200 per beneficiary. Bi-focals and frames limited to R1 870 per beneficiary at a Universal Network optometrist, subject to the AFB.
• Out of hospital physiotherapy – limited to R3 220 PMF (paid from risk). The limit is a combined limit which applies to in and out of hospital services, and forms part of the overall auxiliary benefit limit of R3 220.

Paid From Risk

• Blood pressure, blood sugar, cholesterol, BMI and waist circumference – one measurement per beneficiary over the age of 18 years. Limited to R300 per event.
• Flu vaccinations – one vaccination per beneficiary.
• Unlimited telephonic counselling sessions through the Universal Wellness Care Centre, with an option for referral to one-on-one sessions with qualified psychologists, social workers or registered counsellors to a maximum of 3 referral sessions PB per year.
• Oral contraceptives limited to R200 per beneficiary per month. Subject to medication formulary.
• Pap smear: One per female beneficiary over the age of 18 per annum – paid from risk.
• Mammogram: One per female beneficiary over the age of 35 every second year – paid from risk.
• Prostate-specific antigen (PSA) blood test: Paid from risk, one test per male beneficiary over the age of 40 per annum.

• Not subject to the Annual Flexi Benefit (AFB).
• Services subject to the use of the Universal Provider Network.
• GPs
  • In-Network – Unlimited for clinically necessary services subject to network rules and guidelines.
  • Unlimited face-to-face consultations within the Universal Network. Pre-authorisation may be required from the 4th visit. Virtual consultations unlimited at participating providers.
  • Out-of-Network – 2 visits PB. Limited to R2 080 per event including medicines, pathology, radiology (all related costs). A 20% co-payment applies. Member to pay at point of service and claim back from the Scheme.
• Acute medication – unlimited if prescribed by a Universal Network GP, or by a specialist provided member referred by a Universal Network GP. Subject to formulary. No cover for non-formulary medicines unless otherwise pre-authorised. No cover in case of voluntary use of non-Universal providers, or voluntary use of specialist without referral by a Universal Network GP.
• X-rays for Visa purposes – one chest X-ray paid from risk.
• Basic radiology – Unlimited subject to Universal Care approved codes. Referral from a Network GP required.
• Basic pathology – Unlimited subject to Universal Care approved codes and managed care protocols. Referral from a Network GP required.