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

This page: Costs | Dentistry | Optometry | Wellness and Preventative | Other Medihelp MedPrime Elect We also show benefits for: In-hospital | Out of Hospital | Medicine | Maternity | Cancer | Mental Health | Prosthetics Find all the open medical aid plans here. Compare any two plans side by side, instantly. 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 . Dentistry benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) 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): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) 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): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) 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: (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) 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 .

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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