Coverage Rules & Eligibility Settings
Define how benefits can be used.
Your policy, enforced automatically.
Annual limits
Per-visit caps
Approved treatment types
No more manual checking. No more disputes.
Rules that actually work.
Clear rules, fewer disputes.
Per visit limits
Cap spending per clinic visit to control costs. Set maximum amounts for consultations, medications, and procedures per visit.
Annual limits
Define yearly spending caps for each employee. Track utilisation against limits with automatic alerts and notifications.
Approved treatment categories
Specify which treatments and services are covered. Include or exclude categories like dental, optical, maternity, or specialist care.
Panel-only or open network options
Choose between panel clinics only or allow any clinic. Flexible network settings to balance cost control with employee convenience.
What else Healix can do for your organization?
Future-ready architecture
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Transparent benefits for employees
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Built for trust and governance
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Understand workforce health patterns
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Full control over healthcare spending
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Flexible payment methods
Learn MoreDesigned for national-scale healthcare management.
No obligation. Suitable for private companies and government institutions.