Assume scheme pays all these costs, unless otherwise stated
Optometry:
Limit:
Paid by scheme, every 24 months
Consult:
1 per person
Frames:
R1,040 from network, or R780
Single lenses
100% cost from network, or R215
Bifocals:
100% cost from network, or R460
Multifocals
100% cost from network, or R982
Contacts
R2,010 as alternative to glasses
Refractive Surgery:
R11,673 per eye
Notes:
Above benefits from network provider. Other limits apply to non-network providers.
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.
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
Covered
Pneumonia vaccines:
Covered
Biometric Screening:
Covered
Child Immunisation:
Covered
Pap Smear:
Covered , 18yrs+ every 24 months.
Mammogram:
Covered , women 40yrs+, every 24 months
PAS Test:
Covered , 50yrs+, every 24 months
HIV Test:
Other:
Tempo Programme which includes bio screening, child assessments, nutrition assessments, fitness and nutritional interventions (biokineticist and dietician consults)
Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera: paid by scheme
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
