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
Assume scheme pays all these costs, unless otherwise stated
Optometry:
Limit:
Paid by scheme, every 24 months
Consult:
1 per person
Frames:
R260
Single lenses
100% network rate
Bifocals:
100% network rate
Multifocals
100% network rate
Contacts
R1,255
Refractive Surgery:
no benefit
Notes:
Above benefits from network provider
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.
