ACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES

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1 ACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES WELCOME TO ELIXI MEDICAL INSURANCE BLACK PLAN - PRIMARY AND HOSPITAL CARE Elixi Medical Insurance aims to make private healthcare affordable and accessible to everyone. When you join Elixi Medical Insurance you get a range of plans that have been specifically designed to ensure your most essential and basic healthcare needs are taken care of. From unlimited GP visits and accident and emergency hospital care, to a range of value added services that include trauma counselling, 24hr medical advice and the C5 HIV prevention programme. A description of your Black Plan benefits has been provided in this brochure and a full list of benefits can be found in your policy wording. WHO YOU WILL BE DEALING WITH Talksure: Talksure Trading (Pty) Ltd is an authorised financial services provider (FSP 42788), and offers broker and intermediary solutions with a range of insurance products, including medical insurance. Talksure takes great pride and responsibility in being an FSP and created the Elixi Medical Insurance brand to meet growing customer demand in the medical insurance space. Unity Health: Unity Health is a division of Ambledown Financial Services (Pty) Ltd (FSP 10287). Unity have partnered with Elixi Medical Insurance to help create quality healthcare at an affordable price. Unity are the underwriting managers on behalf of the insurer Constantia Insurance Company Limited (FSP 31111). Unity Health administers the policies sold under the Elixi Medical Insurance brand and manage the network of service providers offered by Elixi Medical Insurance. ER24: Unity Health and Elixi Medical Insurance have partnered with one of South Africa s top providers of emergency medical services. Their services to Elixi Medical Insurance members includes a 24-hour call centre to deal with emergencies, in-patient and out-patient hospital admissions, verifying membership, and issuing guarantee of payments (GOPs) to Elixi Medical Insurance members.

2 BLACK PLAN PRIMARY CARE GP VISITS Unlimited visits at a Unity Health Network GP. Pre-authorisation required for 10 or more GP visits per person, per year. There are over 1700 Network GP s nationwide. To find the nearest Network GP to you, please call us on GP Procedures Minor procedures in rooms are included in your visits to the GP. E.g. stitching of a wound, application of a cast to a broken limb etc. ACUTE MEDICATION Prescribed medication is limited to R6 000 per person, per year. This is limited to medication prescribed during GP visits. All acute medication is subject to a formulary. Dispensing GP: If your GP dispenses medication, you will get everything that you need during your visit. Non-dispensing GP: If your GP does not dispense medication. You will receive a prescription, which you can collect from the pharmacy. What is an acute condition? A short-term condition or illness like a chest infection, sinusitis or the flu. Your GP can give you acute medication to treat your condition/illness, or write a script for you to get the medication at a pharmacy. What is a formulary? A medicine formulary is a list of approved medicines. Only medications that are on this list will be covered. This ensures that premiums stay affordable. SPECIALIST VISITS Specialist visits limited to R2 500 per family, per year. Subject to Network GP referral. CHRONIC MEDICATION Chronic Medication Programme. 10 listed high impact conditions including HIV/AIDS. What is a chronic condition: A condition or disease that lasts for an extended period of time. How does the chronic medication programme work? The Black Plan offers the chronic medication benefit which covers medication for the following specified conditions: asthma, chronic obstructive pulmonary disorder, diabetes (type 1&2), epilepsy, HIV/AIDS, hyperlipidemia, hypertension, tuberculosis, hypothyroidism and glaucoma. OPTOMETRY 1 eye test per person, per year. A standard frame to the value of R254 and one pair of clear standard spectacle lenses per person, per 24 months subject to the qualifying norms as listed in the policy wording. Available at a PPN network optometrist. For a network optometrist near you, please call us on or visit

3 BASIC AND EMERGENCY DENTISTRY For pain and sepsis, including extractions. Up to R1 500 per person, per incident, per 24 months at a Unity Health Network Dentist. Maximum R6 000 per family, per year at a Unity Health Network Dentist. There are over Network Dentists nationwide. To find the nearest Network Dentist, please call us on Treatment includes: Full mouth assessment, intraoral radiographs, scale and polish, extractions, emergency root canal, fillings, pain and sepsis treatment. Only available at a Unity Health Network Dentist. Specialised dentistry (such as bridges or crowns) is not covered. Orthodontic treatment (such as braces or dentures) is not covered. BASIC PATHOLOGY BLOOD TESTS Unlimited blood tests are provided if you receive a referral from your Network GP. Basic list of blood tests subject to a list of tariff codes. During your visit, your GP will advise you if blood tests are necessary. BASIC RADIOLOGY X-RAYS Basic X-rays (black & white) are covered. Subject to a list of tariff codes. Your Network GP will advise you if X-rays are needed. Specialised radiology such as MRI and CT scans are not covered. PRE-BIRTH MATERNITY 3 gynaecologist visits and 3 ultrasound scans per year are covered. Maximum value of up to R4 500 per family, per year. You may go to any gynaecologist, but upfront payment may be required, but will be reimbursed to you. If you prefer to have an ultrasound scan at your Network GP, we will not count this as an additional GP visit. ACCIDENTAL DEATH BENEFIT A benefit equal to R is payable in the event of the death of the principal insured person and/or the spouse of the principal insured due to an accident. Limited to one spouse. WELLNESS SCREENINGS Health screenings include checks for: blood pressure, cholesterol, glucose levels, body mass index, waist circumference, HIV and pre and post test counselling. Available at Dischem and Clicks pharmacies. Limited to one screening per person, per year. PAP SMEARS Available once every 3 years after the age of 21. Available at Clicks and Dischem pharmacies. Your Network GP may or may not offer Pap smears. VACCINATION PROGRAMME Available at approved Dischem and Clicks pharmacies. Influenza: Available annually and needs to be administered by 31 May each year. Tetanus: Available once every 10 years. Hepatitus A & B: Available once-off. Pneumococcal: Available once every 5 years for those aged 60 or older and for those individuals with a medically proven compromised immune system.

4 BLACK PLAN HOSPITAL CARE MRI & CT SCANS - ACCIDENT ONLY Limited to R per insured person, per year. The actual cost of an MRI or CT scan necessitated as a result of an injury sustained due to an accident. Pre-authorisation is required. PHYSIO & OCCUPATIONAL THERAPISTS - ACCIDENT ONLY Limited to R5 000 per insured person, per year. Physiotherapy & Occupational Therapy following an in-patient hospitalisation due to an accident. Limited to a period of 3 months following the discharge from an in-patient hospitalisation incident. Pre-authorisation is required. EMERGENCY STABILISATION - IN-PATIENT EMERGENCY OR CASUALTY UNIT ONLY Limited to R per person, per incident. The actual cost of hospitalisation as an in-patient, in the event of an emergency that necessitates the stabilisation of the patient in an emergency unit before the patient is transferred to a public hospital, excluding any surgical procedures. IN-PATIENT HOSPITALISATION - ACCIDENT ONLY Limited to R per insured person, per incident. The actual cost of hospitalisation as an in-patient, including all associated services during the hospital admission at a private facility in the event of injuries sustained due to an accident. Planned medical procedures are not covered; e.g. hysterectomy, hip replacement. OUT-PATIENT CASUALTY UNIT - ACCIDENT ONLY Limited to R5 250 per person, per incident. The benefit payable for injuries sustained in the event of an accident shall be limited to treatment received in a hospital emergency unit. EMERGENCY SERVICES Emergency evacuation, including: Ambulance services (air or road) Telephonic medical advice Inter-hospital transfers Repatriation of mortal remains within the borders of South Africa Unity Health push to call emergency dialing, geo-locating and find a provider mobile app Hospital pre-authorisation & guarantee of payment to the treating facility in the event of an emergency/accident. All Black Plan Hospital and Accidental Benefits are subject to an overall limit of R per family, per year.

5 VALUE ADDED SERVICES CALL A GP OR NURSE The 24 hour GP helpline is staffed by medical professionals. This critical service provides advice and assistance to all ELIXI MEDICAL INSURANCE BLACK members. Members will be able to discuss a number of medical related matters with a qualified GP and or nurse on the following: medical advice, second opinion, confirmation and clarity of medical diagnosis, guidance on drug regime, guidance to a specialist GP, guidance and advice on the side effects of prescribed treatment, telephonic follow up after diagnosis and treatment. C5 HIV PREVENTION PROGRAMME In the event that an ELIXI MEDICAL INSURANCE BLACK policy holder is exposed to HIV through a trauma or assault, the member will have access to: 24 hour telephonic HIV advice and counselling line, emergency evacuation to HIV treatment facility (ER24 only), medical consultation, 3 day starter pack, 25 day antiretroviral HIV treatment including, sexually transmitted disease therapy and pathology tests. TRAUMA COUNSELLING In the event that an ELIXI MEDICAL INSURANCE BLACK member is involved in a traumatic event or is witness to a traumatic event the member will have access to: unlimited telephonic counselling, referral to a qualified counsellor, and face to face counselling with a qualified counsellor limited to R3 000 per event. HOUSEHOLD ASSISTANCE This service will provide ELIXI MEDICAL INSURANCE BLACK members with a callout and up to one hour s labour (initial fault only), for emergency events that relate to plumbing, electrical faults, faults with appliances, damage to external windows, and emergencies where a locksmith is required. LEGAL ASSISTANCE AND 30 MINUTE FREE CONSULTATIONS Professional, in-house, qualified legal advisors who provide advice to ELIXI MEDICAL INSURANCE BLACK members on any legal topic or matter ranging from debt and divorce to labour and domestic violence, 24/7. The legal service also provides for standard legal documents such as a domestic worker employment contract, maintenance kit, offer to purchase, small claims court kit, Road Accident Fund, etc. To access any of the above benefits, please call us on BLACK PLAN PRICING PER MONTH Principal R665 Senior Principal R918 Adult Dependent R513 Senior Dependent R766 Child Dependent R216 Once-off set up fee for VAPS R60 CONTACT DETAILS TALKSURE CUSTOMER SERVICES/BILLING UNITY HEALTH CLAIMS/QUERIES ER24 ACCIDENT & EMERGENCY Elixi DISCLAIMER: 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 medical scheme membership. The benefits are subject to waiting periods and applicable limits. These are outlined in the policy wording which you are required to read and understand. T&Cs apply. This document is not your policy wording and for the full disclaimer please go to Talksure Trading (Pty) Ltd - an authorised FSP Insurer Constantia Insurance Company Ltd - an authorised FSP

6 Elixi Medical Insurance FAQ s What is the procedure to follow in the event of a medical emergency or serious accident? Call ER24 on The number is also on your Unity Health membership card. ER24 will verify the membership of the person in need of help, whether it be you or your dependant. ER24 will assist you with advice, and emergency transportation to your nearest in-patient hospital facility. ER24 will issue the hospital with a guarantee of payment and you will be admitted for treatment. Please ensure that you have your Unity Health membership card and ID for verification purposes. Unity Health will then settle the account directly with the provider. I did not receive my membership card, who do I contact? Unity Health dispatches the cards once your first premium is collected. Talksure provides the membership certificate which will be used in the interim. Should you not receive your card 45 days after your first premium, please contact Unity Health on or membership@unityhealth.co.za, alternatively, Talksure on or client.services@talksuresa.co.za. What are the waiting periods? Two (2) month waiting period for all benefits, except emergency and accidents which is covered from date of inception. Twelve (12) month waiting period for chronic medication and optometry benefits. Nine (9) month waiting period applicable to pre-birth maternity benefits. Who can be covered under my policy? Immediate family - spouse and children. Elixi Medical Insurance recently launched a chronic medication benefit, how do I receive this benefit and how does it work? The Gold Plan offers the chronic medication benefit which covers medication for the following specified conditions: Asthma, Chronic Obstructive Pulmonary Disorder, Diabetes Type 1&2, Epilepsy, HIV/AIDS, Hyperlipidemia, Hypertension, and Tuberculosis. The Black Plan offers everything listed in the Gold Plan, plus hypothyroidism and glaucoma. Should you wish to upgrade your policy to the Black or Gold Plan, please contact Talksure on or alternatively us on client.services@talksuresa.co.za What process do I follow to add my doctor to the GP list? Call Talksure on or Unity Health on Networks@unityhealth.co.za. Please ensure that you provide us with the doctors name, practice number and contact details. Unity Health will invite the doctor to join the network. The Doctor either rejects or accepts the proposal and it is entirely at the doctors discretion to join. An update will be sent via informing of you of any actions or response. Is Elixi Medical Insurance a medical aid scheme? No, Elixi Medical Insurance is not a medical aid scheme and the cover is not the same as a medical aid scheme. Elixi Medical Insurance is classified as short term medical insurance. Can I go to any doctor across South Africa? We have a network of doctors in the 9 provinces. For more information on the location of the doctors, please contact Talksure on What is an emergency? An event or unexpected health condition, which if not treated immediately, would result in death or serious bodily impairment. E.g. Heart attack or stroke. What is an accident? An accident means bodily injury caused by violent accidental and external physical means. E.g. Motor vehicle accident, burns, injuries from a crime, snake bite or injuries from a fall.