Medshield MediPhila:
dentistry, optometry and wellness (2025)

This page has information on: Costs, Dentistry, Optometry, Wellness and Preventative and Other benefits for Medshield MediPhila

• View all the Medshield plans, with costs and brief summary.
• View all open medical aid plans.
• Compare any two plans side by side, instantly.

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)

Medshield: MediPhila
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. Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R4,700 per family Other Day-to-Day Funds:
Standard Dentistry:	R1,800 per family, from overall R7,300 dentistry limit
Specialised Dentistry:	R7,300 per family Wisdom Teeth and Apicoectomy: R4,000 co-payment if done in-hospital and R1,800 co-payment if done in day clinic. Crowns, Bridges, Inlays, Mounted Study Models, Partial Metal Base Dentures and Periodontics: No benefit.	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
In-Hospital Dentistry:	Under 6yrs: Unlimited Wisdom Teeth and Apicoectomy: R4,000 co-payment if done in-hospital and R1,800 co-payment if done in day clinic. Part of Specialised Dentistry limit. Maxillo-Facial and Oral surgery: R23,000 per family	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Orthodontics:	No benefit

Optometry benefits (2025):

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

Medshield: MediPhila
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. Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account R4,700 per family Other Day-to-Day Funds:
Optometry:	R1,500 per person, every 2 years
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)

Medshield: MediPhila
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:	Covered
Pneumonia vaccines:	No benefit
Biometric Screening:	Covered
Child Immunisation:	Covered, up to 12 yrs
Pap Smear:	Covered
Mammogram:	No benefit
PAS Test:	Covered
HIV Test:	Covered
Other:	TB test: 1 per person
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 Medshield plans, with costs and brief summary. Find all other open medical aid plans here.

Other benefits for 2025:

MediPhila
International Insurance:	.
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.