Medihelp MedPrime Elect:
dentistry, optometry and wellness (2025)

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Medihelp MedPrime Elect

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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 Providers. Where stipulated, you must use 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)

Dentistry benefits (2025):

(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
Main Member: Adult: Child: Savings: R5,888 R4,842 R1,656 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R7,550 Main+1= R13,900 Other Day-to-Day Funds:
Standard Dentistry:	Paid by scheme
Specialised Dentistry:	Dentures: One frame per person, every 5 years Crowns and bridges: One crown per family, every 5 years Implants: No cover Above is paid by scheme	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
In-Hospital Dentistry:	Impacted wisdom teeth: Dentist account paid by scheme, if done in-chair, otherwise R1,850 co-payment Treatment for children <7yrs: R1,850 co-payment Maxillofacial surgery: Unlimited	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Orthodontics:	R11,160 per person, per lifetime

Optometry benefits (2025):

(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
Main Member: Adult: Child: Savings: R5,888 R4,842 R1,656 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R7,550 Main+1= R13,900 Other Day-to-Day Funds:
Optometry:	Every two years, paid by scheme Eye test and lenses Frame/lens enhancement: R910 Contact Lenses: R1,310 Refractive Surgery: R14,300 per family, paid by scheme
Note:	This section does not apply to ophthalmology 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)

Medihelp: MedPrime Elect
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:	Covered
Pneumonia vaccines:	No benefit
Biometric Screening:	Covered
Child Immunisation:	Covered, up to 7yrs
Pap Smear:	Covered, every 3 years
Mammogram:	Covered, every 2 years
PAS Test:	Covered
HIV Test:	Covered
Other:	Tetanus injection An FOBT test A bone mineral density test
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 Medihelp plans, with costs and brief summary. Find all other open medical aid plans here.

Other benefits for 2025:

MedPrime Elect
International Insurance:	No benefit
Other:

Important!
• Unless specified, assume that all benefits 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.