Unisure International Private Medical Insurance (IPMI) is a globally portable health insurance solution for Employer Groups with Employees living and working across borders. It provides core cover for Inpatient care, Emergencies and Evacuation, Oncology Benefits, Maternity and Family Benefits, Chronic Conditions, and Wellness Benefits, with optional Group add-ons for Day-to-Day Outpatient, Optical and Dental Benefits. The product, which also includes access to wellness and the digital add-ons Teladoc and Unisure Strove App, is designed to be simple, scalable, and suitable for internationally mobile workforces.

The Plan Options are Access, Essential, Classic, Prestige and Summit, with annual limits of USD 250,000, USD 500,000, USD 1,500,000, USD 3,000,000 and USD 5,000,000, respectively. Benefit levels, including Sub-Limits and scope of cover, increase with each tier.

All Plan Options include core benefits for Inpatient Care, Emergency and Evacuation, Oncology Benefits, Mental Health Benefits, Maternity and Family Benefits, Wellness Benefits, and Chronic Conditions. These core benefits are included as standard across Access, Essential, Classic, Prestige, and Summit, with higher tiers offering richer limits and Sub-Limits.

For Group business, the optional add-ons are (1) Outpatient and (2) Optical and Dental benefits.

• Outpatient is optional for Employers and provides cover for consultations, treatment, diagnostics, and prescribed medication, with tiered limits ranging from USD 1,000 on Access to Paid in Full on Summit, subject to the Overall Annual Limit.
• Optical and Dental can only be added once Outpatient has been selected. These benefits are also tiered by Plan Options and have their own limits.

For more details on Outpatient and Optical and Dental benefits, see the later coverage FAQs.

The maximum value of benefits per Member, during the Period of Coverage, normally a calendar year, from the Policy Inception Date, which varies from Policy to Policy as selected by the Employer. Overall Annual Limit is the maximum sum insured payable for the Policy.

The Last Expense Benefit is an optional add-on for Group IPMI only. It provides a lump-sum payment on the death of a Member, with the amount linked to the Plan Option selected by the Employer. The benefit amounts are USD 1,000 for Access, USD 2,000 for Essential, USD 3,500 for Classic, USD 4,250 for Prestige, and USD 5,000 for Summit. The benefit is designed to be respectful of local practices.

The Area of Cover is the geographical scope within which the Policy provides protection and pays valid claims. It defines where in the world the Policy benefits are applicable to the Membership Cover.

For full details of the applicable Area of Cover, please refer to your Membership Guide.

There are 3 Areas of Cover that your Employer can choose from: (1) Africa and India; (2) Asia; and (3) Worldwide cover excluding the United States of America (USA).

The selected Area of Cover determines where treatment may be received. Certain countries and/or regions may also be excluded due to sanctions, conflict, or limited healthcare access.

No. Area of Cover changes are only allowed at the Policy anniversary. Treatment obtained outside your Area of Cover without Pre-Authorisation will be declined.

Yes, but only in line with your selected Area of Cover and the terms of the Employer’s Policy. If treatment takes place outside the selected Area of Cover without Pre-Authorisation, the cost will generally be declined. Prestige and Summit include Emergency Outside Area of Cover for Emergencies and acute episodes of existing covered conditions when Worldwide cover excluding the USA is selected, subject to the limits and terms of the chosen Plan Options.

Multi-currency options are available. Premiums and benefits can be handled in USD, EUR, or GBP, aligned with the Employer selection. Claims are reimbursed in line with the claim currency otherwise in the benefit currency.

Yes. The product is designed as a single-Policy international solution for Employers with Employees who live and work across multiple countries. Members remain covered as they move between regions, subject to the Policy terms, Area of Cover, and eligibility rules.

Group coverage is available to Employer Groups, including Employer of Record (EOR) arrangements, with a minimum of three Principal Members maintained at all times. Falling below this threshold may result in immediate Policy termination. Eligible Employees include full-time and part-time staff, contractors, sub-contractors, and EOR placements, provided there is a valid legal employment contract between the Employer (Policyholder) and the Member covered under the Policy.

For Group plans, Employees may join up to age 75 if still actively employed under a contract of employment, and Employees over 75 may be considered on a case-by-case basis. Individuals who are not actively employed by the Employer may only join up to age 65, and Dependants may join up to age 65. Cover ends at age 80 for all Members.

• Spouse/Partner (legal or common-law);
• Biological or legally adopted children;
• Biological or legally adopted children who are studying (up to 25 years, proof from the tertiary institution is required);
• Dependants with disabilities who are dependent on the Principal Member (with medical evidence if requested);
• Parents (in special circumstances where such parents are dependent on the Principal Member subject to medical evidence and approval).

All Dependants must be linked to a Principal Member.

Applicants must reside within the approved Area of Cover and not in Excluded Regions, such as countries affected by Sanctions, conflict, or inadequate healthcare access. If a Dependant resides in an Excluded Region, this must be agreed in writing by the Insurer and reinsurer and noted on the Membership Certificate.

US citizens may be covered if they live outside the USA, but the Policyholder cannot be a US company.

Underwriting is the process used by the Insurer to assess risk and set the terms and cost of Policy. For Group Policies, the Underwriting method is selected by the Policyholder, subject to Insurer approval.

The main Underwriting options are Full Medical Underwriting (FMU), Medical History Disregarded (MHD), Continued Personal Medical Exclusions (CPME), and Moratorium.

• FMU requires Members to complete a comprehensive medical questionnaire, and the Insurer may request access to medical records, additional tests, or interviews. Based on this information, the Insurer determines whether cover can be offered and set any terms relating to Pre-Existing Conditions.
• MHD provides comprehensive cover for all Members regardless of Medical History, offering peace of mind to both Members and Employers. Members are not required to declare Pre-Existing Conditions, and past Medical History is not considered. All conditions are covered, subject to standard Waiting Periods and Policy Exclusions.
• CPME the Insurer continues the same Exclusions and terms applied by a previous Insurer, ensuring continuity of cover without requiring a new full medical assessment. This option avoids gaps in cover and simplifies the transition between Insurers. Waiting Periods already served under the previous Policy are generally waived for equivalent benefits, although standard Waiting Periods may apply to new or enhanced benefits not previously covered.
• Moratorium allows Members to join without completing a detailed medical questionnaire. Instead, Pre-Existing Conditions are excluded for a fixed period. If a Member remains symptom-free and does not seek treatment, advice, or medication for the condition during that time, the Pre-Existing Condition may become eligible for cover.

Members must always provide accurate information during onboarding and should check their Membership Certificate for any special terms, Exclusions, or Waiting Periods.

Cover for Pre-Existing Conditions depends on the Underwriting method selected by the Employer. FMU may cover certain Pre-Existing Conditions following a questionnaire and if applicable a medical assessment. MHD generally covers Pre-Existing Conditions without the need for medical disclosure. CPME continues the Exclusions and terms from the previous Insurer. Under Moratorium, Pre-Existing Conditions are excluded initially and may only become eligible once the moratorium rules have been met.

Hospital admission (overnight and Day Cases), diagnostics (radiology, scans), ICU, Surgery, Specialist fees, and case management. Coverage is subject to Pre-Authorisation and Table of Benefits (TOB) limits.

Yes. Maternity and Family Benefits include eligible Routine Childbirth, Medically Essential Caesarean Sections, and related maternity care, subject to the Table of Benefits, plan limits, and a 10-month Waiting Period for Ante-natal and routine Inpatient maternity treatment.

Medically Essential Caesarean Sections require Pre-Authorisation. If medical necessity cannot be confirmed, the claim will usually be paid from the applicable Maternity and Family Benefit limit, subject to plan terms.

If the Day-to-Day Outpatient Benefit is selected, it provides cover for Doctor and Specialist consultations, prescribed medication, Diagnostic Tests, and other eligible Day-to-Day medical treatment, subject to the limits and terms of the selected Plan Option.

Optical and Dental benefits are available only if the Day-to-Day Optical and Dental Benefit option has been added. Optical Benefits include eye tests and contributions towards frames and lenses, while Dental Benefits include routine, preventative, and certain restorative treatment, all subject to plan limits, Co-payments, and any Pre-Authorisation requirements.

Yes. Core plans include Mental Health Benefits, and where the Outpatient option is selected, eligible Outpatient mental health treatment and prescribed medication may also be covered, subject to the Table of Benefits, Waiting Periods, and the Policy terms.

Yes. Chronic Conditions are covered in line with the Table of Benefits and the applicable Underwriting terms. Cover typically includes eligible Specialist care, prescribed medication, and hospitalisation for listed Chronic Conditions, without reducing the standard Outpatient limit where the benefit is separately defined.

Yes. Cancer treatment and Surgery are covered as part of the Oncology Benefits, subject to the Table of Benefits and Policy terms. The Policy also includes enhancements such as medically motivated genome testing, and, where applicable, access to Evacuation for treatment and support benefits linked to the selected option and Policy terms.

Yes. Preventative screenings and routine health checks are included as set out in the Table of Benefits. The exact screenings, frequency limits, and age criteria depend on the selected Plan Option and Policy terms.

Vaccination cover is subject to the Table of Benefits and Policy terms. Routine immunisations and certain other vaccinations may be included, depending on the benefit wording applicable to the selected option.

Cancer genetic testing is covered subject to a 12-month Waiting Period and clinical appropriateness. Predictive genetic tests for non-present disease are excluded (see Exclusions in the Membership Guide).

Certain Congenital Conditions may be covered only where this is specifically provided for in the Table of Benefits and subject to the stated Waiting Periods, Lifetime Limits, and newborn cover rules. Hereditary or genetic conditions remain excluded unless explicitly stated as covered.

Yes, where medically necessary and authorised. This may include local road or air ambulance transport for Emergencies, and medical Evacuation to the nearest appropriate Centre of Excellence when suitable treatment is not available locally.

Yes. Emergency Evacuation is covered when medically necessary and authorised, usually to the nearest suitable Centre of Excellence where the required treatment is available. The type of transport used will depend on the clinical situation and the approved treatment plan.

A Centre of Excellence is a medical facility within the Policy Administrator-approved network that meets recognised international standards for Specialist care, clinical expertise, patient safety, and treatment outcomes. These facilities are selected for their ability to provide high-quality, advanced medical treatment for complex or serious conditions.

Yes. Teladoc provides three core services: Expert Medical Opinion, Primary Care Teleconsultation, and Body Care. Expert Medical Opinion is available Monday to Friday during CET business hours, Primary Care Teleconsultation is available 24/7/365 in English, and Body Care combines virtual Physiotherapy support with digital Rehabilitation tools.

Teladoc’s Body Care service combines consultations with licensed physiotherapists and digital Rehabilitation support to help Members improve mobility, posture, and recovery. Depending on location, the digital support may include exercise programmes and progress tracking.

Wellness Benefits include preventative screenings, health checks, and immunisations as set out in the Table of Benefits. In addition, the Unisure Strove App provides a digital wellbeing platform with activity tracking, challenges, educational content, rewards, and wellbeing tools. Some Unisure Strove services, such as Talk and Nourish, may be offered as buy-up options at the Employer’s expense (for further information, the Employer is requested to discuss with the Policy Administrator or their intermediary).

Pre-Authorisation is approval obtained before certain treatments or services are provided. It helps confirm that the treatment is covered, clinically appropriate, and within the terms and limits of your Employer’s Policy.

Pre-Authorisation is especially important for Inpatient treatment, Day Cases, medical Evacuation, and certain high-cost Outpatient services. It helps confirm cover in advance, supports access to Direct Settlement where available, and allows treatment plans and expected costs to be reviewed before care is provided.

• For Inpatient Hospital admissions (overnight or Day Cases).
• For Elective Procedures (planned Surgeries).
• For high-cost Outpatient services (e.g., MRI, CT scans).
• For medical Evacuation or Repatriation.

Contact Unisure Assist by phone on +230 58 690 100 or +27 87 238 2600 or submit a request through the online Portal. For Emergencies, the numbers are +44 203 885 3921, +27 87 238 2600, and +230 5869 0100. For Elective Procedures, a detailed medical report should be provided at least 30 days before admission.

Membership details; proposed treatment/admission date; symptoms onset; diagnosis; ICD-10 Codes; itemised cost estimates for all providers; treating facility and Doctor contacts; expected length of stay; and supporting diagnostics (X-rays, scans, labs, medical report).

Direct Settlement means an In-Network Healthcare Provider submits the claim directly to the Policy Administrator under an existing direct billing arrangement. For Inpatient treatment, this usually applies when treatment is Pre-Authorised. In certain territories, some In-Network Outpatient services may also be settled directly where operational arrangements support this. A Guarantee of Payment is a formal written confirmation issued by the Insurer or Policy Administrator to a Healthcare Provider stating that the Insurer will pay the covered costs of specified medical treatment for a Member, subject to the terms, limits and conditions of the Policy.

Pay-and-Claim means the Member pays the Healthcare Provider first and then submits a claim for reimbursement through the Portal. This applies to out-of-network treatment and generally to most Outpatient care unless a direct billing arrangement is available. Claims should be submitted within 90 days of treatment.

Claims are reimbursed within 7 working days from the date all information has been provided (i.e. the date of assessment). You will receive a claims statement confirming the approved reimbursable amount once the claim has been assessed.

Yes. Members can submit claims through the Portal and track their status online. A claim form is also available for email submissions where needed.

If You use an Out-of-Network Healthcare Provider, You will usually need to pay first and claim back. Reimbursement remains subject to your plan terms, benefit limits, and Policy conditions. Treatment outside your Area of Cover without Pre-Authorisation will generally not be covered.

A Waiting Period is the amount of time You must remain on your health insurance plan, with all contributions paid up to date, before certain benefits become available. It starts from the Membership Cover Start Date and applies to specific treatments or conditions.

• They help prevent anti-selection (joining a plan only when You need expensive treatment).
• They ensure fairness and sustainability for all Members.

Yes, under most Underwriting types (FMU, Moratorium, MHD). If your Employer’s Policy uses CPME, Waiting Periods already served with your Employer’s previous Insurer may be waived for the same benefits.

Tip: Always check your Membership Certificate and Table of Benefits (TOB) for details on Waiting Periods that apply to your Employer’s Policy and You.

• Maternity and Family Benefit (including Ante-natal and routine Inpatient): 10 months.
• Infertility treatment: 18 months.
• Dental (routine & preventative): 3 months.
• Dental (basic restorative, minor periodontal & major restorative): 6 months.
• Orthodontic: 12 months.
• Cancer genetic testing: 12 months.
• Oncology Benefit (cash): 6 months.
• Mental Health Benefits: 18 months (see exception in question 60 below).
• HIV treatment: 3 months (Groups) and 12 months (individuals).
• Musculoskeletal and joint problems: 12 months, except in the case of a life- or limb-threatening Emergency.

A Co-payment is either a fixed value or a percentage that is payable by the Member when they receive specific medical services or treatment. There are Co-payments applicable to some of the Outpatient benefits and it is dependent on the Plan Option selected by the Policyholder.

• Routine and basic restorative dental: 20% co-pay.
• Orthodontic and major restorative dental: 50% co-pay.

Elective cosmetic or appearance-enhancing procedures are excluded. Reconstruction following cancer Surgery may be covered when Pre-Authorisation is obtained; cosmetic dental implants are excluded.

Slimming aids/classes, anti-obesity medicines (including semaglutide) and bariatric/gastrointestinal procedures are excluded.

Exception: If the Outpatient option is selected and a diagnosis of Type 2 diabetes, prescribed semaglutide medications may be covered within the Prescribed Medication limit. Prescribed Medication Limit means the maximum quantity, frequency, duration, or monetary amount of prescribed drugs or medications that the Insurer will cover for a Member within a specified period, subject to the terms and conditions of the Policy.

No. Treatments/medicines considered experimental or used outside licensed indications are excluded unless Pre-Authorisation is obtained.

Initial diagnosis/treatment of Epidemic/Pandemic diseases, preventive treatments and non-medical quarantine/isolation costs are excluded. (Policy terms take precedence.)

Intentional self-inflicted injury and illegal substance use are excluded. The Insurer may require tests where substance influence is suspected. (See Table of Benefits for any conditional Exceptions.)

Professional/competitive/high-risk sports may be excluded unless specifically rated and accepted. Members must follow Norms of Safety; some motorised racing and aviation/nautical activities are excluded unless agreed.

Mechanical/animal organ transplants, donor organ removal, stem cell storage as a preventive measure, and purchase of donor organs are excluded. Cancer-related stem cell procedures may be covered per the Table of Benefits.

Mental Health Benefits are included under the Policy, but certain Exclusions still apply. In particular, treatment for personality disorders is excluded. Members should refer to the Table of Benefits, Waiting Periods, and Policy wording for the exact scope of cover and Exclusions that apply.

Investigations and treatment related to birth control, infertility, and assisted reproduction are generally excluded unless specifically included under the Plan Option. On Summit, infertility treatment is covered up to the defined benefit limit and remains subject to Pre-Authorisation, clinical criteria, Waiting Periods, and any applicable Co-payments. Surrogacy-related treatment is excluded across all Plan Options.

On the Member Portal, Members can view their cover details, submit and track claims, download claim statements and Membership documents, request Pre-Authorisation, search for Healthcare Providers, and update certain personal details such as contact and banking information. The Member can also access the Unisure Strove App and Teladoc platform.

Log into the Member Portal, complete the claim details, and upload the required supporting documents such as the itemised invoice and proof of payment. Where needed, Members may also submit claims by email using the claim form included in the Membership Pack.

Yes. The Healthcare Provider search tool helps Members find contracted In-Network Healthcare Providers based on location.

The Unisure Strove App is a digital wellbeing platform that helps Members build healthier habits through activity tracking, challenges, rewards, well-being content, and analytics. Some additional services, such as Talk and Nourish, may be available as Employer-funded buy-up options.

Teladoc offers Expert Medical Opinion, Primary Care Teleconsultation, and Body Care. These services provide Members with access to Specialist medical input, virtual primary care support, and Physiotherapy-led digital Rehabilitation, subject to service availability and language options.

Yes, the Unisure Strove App includes a points and rewards marketplace (Travel, environmental, lifestyle rewards). Employer-specific rewards and buy-up options may be offered based on the Group configuration.

You can check your Membership Cover details on the Member Portal and on your Membership Certificate and virtual card.

One calendar year from the Policy Inception Date, renewing on the anniversary provided premiums are paid in advance and up to date.

If premiums are unpaid beyond 30 days from invoice, the Policy is suspended (Members remain on risk but claims not processed). After 45 days from suspension, the Policy is Cancelled from the date of suspension. Lapsed Policies require reinstatement as a new insurance Policy unless otherwise agreed in writing.

Groups may allow one mid-year change to another plan already selected by the Policyholder, subject to a short medical questionnaire. Otherwise, changes occur at Policy anniversary.

If renewal is confirmed on time, the cover under the Policy continues. If renewal is confirmed after the Renewal Date, the Policy is deemed Lapsed and reinstatement is treated as a new Policy; Members may be re-underwritten with new terms.

Yes, subject to Employer rules and submission of required documents. New Dependants require a new application and may be subject to Underwriting and Waiting Periods.

KYC and onboarding requirements depend on the Policyholder structure, Insurer, and territory. Employers must provide the required business and identification documents, while Employee enrolment data must include the Principal Member details needed for onboarding. Additional medical questionnaires may be required for older entrants, depending on age and Underwriting rules.

Welcome letter, claim form, Membership card, Membership Certificate, brochure, Membership guide, and important Member information. Electronic packs are sent via email; printed packs are optional.

Please refer to our Complaints Policy and Procedure for details on how to submit a complaint, including the complaint process and contact details.