Medihelp MedPrime Elect: dentistry, optometry and wellness (2024)

Monthly Costs:

MedPrime Elect 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R3,918	R3,306	R1,140 Only pay for 2 children under 18yrs
Savings:	R4,680	R3,960	R1,368
Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account	Main= R6,900 Main+1= R12,700
Children Rates:	Child rates up to age 26. Only pay for 2 children under 18yrs
Note:	Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list. All treatments and procedures are subject to authorisation and protocols All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Medihelp plans, with costs and brief summary
.

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Dentistry benefits (2024):

Medihelp: MedPrime Elect
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:	Routine check ups, fillings, x-ray, extractions, root canals, oral hygiene: Covered by scheme
Specialised Dentistry:	Plastic Dentures: one set per person, every 4 years Partial metal frame dentures: one partial frame per person every 5 years Crowns and bridges: 1 crown per family Implants: No benefit Periodontics: Covered, with protocols Maxillofacial surgery in dentist chair: Unlimited Paid by scheme
In-Hospital Dentistry:	Impacted wisdom teeth, under 12yrs: paid by scheme, if done in-chair, Impacted wisdom teeth, in hospital R1,750 co-payment Extensive treatment for children under 7yrs: R1,750 co-payment	PMBs are always covered by the scheme, and cannot have sublimits or co-payments imposed. These include fracture of face bones, orbit and/or jaw. You can see a full list of maxillo facial PMB benefits here.
Orthodontics:	R10,630 per person, per lifetime Paid by scheme
Note:	PMBs: Prescribed Minimum Benfits. To read more about PMBs click here DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit. Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Medihelp plans, with costs and brief summary
.

Optometry benefits (2024):

Medihelp: MedPrime Elect
Assume scheme pays all these costs, unless otherwise stated
Optometry:	Every two years: Eye test and lenses Frame/lens enhancement: R865 Contact Lenses: R1,270 Refractive surgery: R13,700 per family, 18-50yrs
Note:	This section does not apply to opthamology benefits, which fall under "in-hospital" benefits. Some of those are PMBs, and are paid for in full by your scheme. You can read more about PMBs here.
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Medihelp plans, with costs and brief summary
.

Wellness/Preventative benefits (2024):

Medihelp: MedPrime Elect
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:	Covered
Pneumonia vaccines:	Covered, 55yrs+ if registered for asthma or COPD
Biometric Screening:	Covered
Child Immunisation:	Covered , up to 6yrs
Pap Smear:	Covered , every 3 years
Mammogram:	Covered , every 2 years
PAS Test:	Covered
HIV Test:	Covered
Other:	Tetanus injection:Covered An FOBT test A bone mineral density test
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Medihelp plans, with costs and brief summary
.

Other benefits for 2024:

MedPrime Elect
International Insurance:	No benefit
Other:
♦️View all the other benefits for this plan:♦️ Inhospital \| Out of hospital \| Medication \| Maternity \| Cancer \| Mental Health \| Dentistry \| Optometry \| Other/Extra Benefits \| Wellness \| Prosthetics You can also: ♦️Compare any two plans, side by side \| ♦️View all the Medihelp plans, with costs and brief summary
.

Important!

Unless specified, assume that all benefits are paid are paid at 100% scheme rate
No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
"Unlimited" benefits are still subject to authorisation, protocols and sublimits
Assume that all benefits need to be pre-authorised

All the medical aid jargon explained (2024)

Medical aid and PMBs? DSPs? PPNs? We decipher the medical aid jargon in plain English so that you are not as confused 🙂

How do I make a medical aid plan change (2024)?

A quick guide to how you can change your medical aid plan, including the resignation procedure, and things to look out for, such as imposed waiting periods from your new scheme

Medical Aid waiting periods: what you need to know (2024)

Waiting periods can prevent you from getting the cover that you need – but they are not always applied. Find out rules here.

Medihelp MedPrime Elect: dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2024):

Optometry benefits (2024):

Wellness/Preventative benefits (2024):

Other benefits for 2024:

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

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dentistry, optometry and wellness (2024)

Sizwe Silver Hospital:
prosthetic benefits (2024)