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Medihelp Prime 3: dentistry, optometry and wellness (2021)

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This page shows the Dentistry, Optometry, and Other Benefits for Medihelp Prime 3.

Pricing:

Prime 3
Main member: Adult member: Child member:
Total Cost pm: R3,828 R3,240 R1,116
Pay for max 2 children under 18yrs
Savings: R4608 R3888 R1368
Children Rates:
  • Under 26yrs
  • Pay for max 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 other benefits:
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:

Prime 3
Standard Dentistry:
  • Paid by scheme, including a set of plastic dentures per person, every 4 years
Specialised Dentistry:
  • Partial metal frame dentures: 1 partial frame per person, every 5 years
  • Crowns and bridges: 1 crown per family
  • Implants: No benefit
  • Peridontal treatment: Covered
In-Hospital Dentistry: When will this be updated?
Orthodontics:
  • R9,350 per person, once per lifetime
  • Under 18yrs only
Maxillo Facial Surgery:
  • Covered
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 other benefits:
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:

Prime 3
Optometry:
Limit:
Consult:
Frames:R800, or lens enhancement
Single lensesPaid
Bifocals:Paid
MultifocalsPaid at bifocal rates
ContactsR1,200
Refractive Surgery:R12,000 per family, for 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 other benefits:
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 Benefits:

Prime 3
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • Covered for 55+yrs if registered for asthma or COPD
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered, up to 7 years
Pap Smear:
  • 1 covered, females 18yrs+, every 3 years
Mammogram:
  • 1 covered, females 40-75yrs, every 2 years
PAS Test:
  • 1 per year, males 40yrs+
HIV Test:
  • 1 per year
Other: .
View other benefits:
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:

Prime 3
International Insurance: When will this be updated?
Other: When will this be updated?
View other benefits:
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

    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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