Cape Medical MyHealth 200:
dentistry, optometry and wellness (2025)

Table of Contents:

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Cape Medical 200 View all the Cape Medical plans, with costs and brief summary.

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Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • 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
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Cape Medical :MyHealth 200 (2025)
Main member: Adult member: Child member:
Total Cost pm:
  • R3,577
  • R3,577
  • R631
  • Under 21yrs
Savings:
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:
  • Under 21yrs

Dentistry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Cape Medical : MyHealth 200
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:
Standard Dentistry:
  • R681 per person, paid by scheme
  • Then, From day-to-day benefit
Specialised Dentistry:
  • From day-to-day benefit
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
In-Hospital Dentistry:
  • General dentistry under general anaesthetic or conscious sedation: For children under 7yrs, paid by scheme
  • In-hospital: Covered, if hospitalisation required
  • Maxillo-facial : 100% scheme rate, if approved
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Orthodontics:
  • From day-to-day benefit

Optometry benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Cape Medical : MyHealth 200
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:
Optometry:
  • Eye exam: R500, per child
  • Otherwise, from day-to-day benefit
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.

Wellness/Preventative benefits (2025):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Cape Medical : MyHealth 200
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • For patients with asthma or chronic obstructive pulmonary disease
Pneumonia vaccines:
  • No benefit
Biometric Screening:
  • Blood tests covered
Child Immunisation:
  • No benefit
Pap Smear:
  • On request from doctor
Mammogram:
  • R1,987 per person with R300 co-payment, for women 49yrs+, every 2 yrs
PAS Test:
  • Covered
HIV Test:
  • Covered
Other:
  • Bone density: scheme rate, for 50yrs+, every 5 yrs
  • Blood tests, incl blood glucose, cholesterol and thyroid screening, and COVID-19 testing: Covered by scheme
View other benefits for this plan:
In-hospital | 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 Cape Medical plans, with costs and brief summary.

Find all other open medical aid plans here.

Other benefits for 2025:

MyHealth 200
International Insurance:
  • No benefit
Other:

    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

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What does a “PMBs only” restriction mean?
In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

What does “From Risk” mean?
The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

What is a DSP?
A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover. 

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