Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:
From day-to-day benefit
Specialised Dentistry:
Specialised dentistry: from day-to-day benefit, up to R16,400 per person and R42,000 per family. This includes both in and out-of-hospital benefit.
Wisdom teeth, in chair: R1,670 co-payment . Paid by scheme.
In-Hospital Dentistry:
Maxillo-facial surgery and general anaesthesia for children under 7yrs: Hospital and anaesthetist accounts paid by scheme, with R1,670 co-payment. Surgeon, dental and dental specialist accounts paid from day-to-day benefit
Wisdom teeth: Paid by scheme with:
Day hospital: R3,300 co-payment
Overnight hospital: R6,150 co-payment
Assume scheme pays all these costs, unless otherwise stated
Optometry:
R5,030 per person, from day-to-day benefit
Frame: R2,740, from above limit
Refractive Surgery: See overall limit, above
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.
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
