Medshield Premium Plus:
dentistry, optometry and wellness (2024)

Monthly Costs:

Premium Plus 2024 prices
	Main member:	Adult member:	Child member:
Total Cost pm:	R7,842	R7,185	R1,500 Only pay for 3 children (excl students)
Savings:	R18,816	R17,244	R3,600
Self Payment Gap: (What you need to pay out of pocket before you can access the "Above Threshold" benefit)	R3,684	R3,556	R600
"Above Threshold" benefit (ATB): Additional cover the scheme makes available to you, once you've paid* the self payment gap.*	R6,100	R4,400	R3,050
Children Rates:	Under 21yrs, or students under 28 yrs Only pay for 3 children (excl students)
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 Medshield plans, with costs and brief summary
.

You'll get the printable guide as well as a weekly newsletter 🙂

Dentistry benefits (2022):

Medshield: Premium Plus
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:	From day-to-day benefit
Specialised Dentistry:	R19,300 per family Wisdom Teeth and Apicectomy: R2,000 co-payment if done in-hospital. Part of above limit
In-Hospital Dentistry:	Under 6yrs: Unlimited Wisdom Teeth and Apicectomy: R2,000 co-payment f in hospital, no co-payment if done in rooms. Part of specialised dentistry benefit.	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:	See "Specialised Dentistry"
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 Medshield plans, with costs and brief summary
.

Optometry benefits (2022):

Medshield: Premium Plus
Assume scheme pays all these costs, unless otherwise stated
Optometry:	1 pair per person, from savings account, every 2 years. Sublimits apply. Above Threshold benefit does not apply Readers: R180 per person Refractive surgery: R18,940 per family
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 Medshield plans, with costs and brief summary
.

Wellness/Preventative benefits (2022):

Medshield: Premium Plus
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:	Up to R100
Pneumonia vaccines:	Covered , 60yrs+
Biometric Screening:	Covered
Child Immunisation:	Covered , up to 12 yrs
Pap Smear:	Covered
Mammogram:	Covered , 40yrs+ every 2 yrs
PAS Test:	No cover
HIV Test:	Covered
Other:	Adult vaccines: R1,700 per family Bone density: 1 per person, 50yrs+, every 3 yrs TB test: 1 per person
♦️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 Medshield plans, with costs and brief summary
.

Other benefits for 2022:

Premium Plus
International Insurance:	.
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 Medshield 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

All the medical aid jargon explained (2024)

Medical aid and PMBs? DSPs? PPNs? We decipher the medical aid jargon in plain English so that you are not as confused 🙂

How do I make a medical aid plan change (2024)?

A quick guide to how you can change your medical aid plan, including the resignation procedure, and things to look out for, such as imposed waiting periods from your new scheme

Medical Aid waiting periods: what you need to know (2024)

Waiting periods can prevent you from getting the cover that you need – but they are not always applied. Find out rules here.

Medshield Premium Plus:
dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2022):

Optometry benefits (2022):

Wellness/Preventative benefits (2022):

Other benefits for 2022:

All the medical aid jargon explained (2024)

How do I make a medical aid plan change (2024)?

Medical Aid waiting periods: what you need to know (2024)

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dentistry, optometry and wellness (2024)

Sizwe Silver Hospital:
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Medshield Premium Plus: dentistry, optometry and wellness (2024)

Monthly Costs:

Dentistry benefits (2022):

Optometry benefits (2022):

Wellness/Preventative benefits (2022):

Other benefits for 2022:

Also see these:

Medshield Premium Plus:
dentistry, optometry and wellness (2024)