Profmed ProActive Plus Premium:
dentistry, optometry and wellness (2025)

What's on this page:

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Profmed ProActive Plus Premium View all the Profmed plans, with costs and brief summary.

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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 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
  • 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 (2025)

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

Profmed: ProActive Plus Premium (2025 prices)
Main member: Adult member: Child member:
Total Cost pm:
  • R3,286
  • R3,028
  • R1,280
  • Pay for all children
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
  • Main= R4,548
  • Main+1= R6,452
  • Max per family= R8,039
Children Rates:
  • Up to age 21yrs, unless student, then 28yrs
  • Pay for all children

Dentistry benefits (2025):

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

Profmed: ProActive Plus Premium
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
  • Main= R4,548
  • Main+1= R6,452
  • Max per family= R8,039
Standard Dentistry:
  • From day-to-day benefit
Specialised Dentistry:
  • From day-to-day benefit
In-Hospital Dentistry:
  • Wisdom teeth and treatment for children <8yrs: 100% scheme rate
  • Orthognathic surgery: PMBs only
Orthodontics:
  • From day-to-day benefit

Optometry benefits (2025):

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

Profmed: ProActive Plus Premium
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
  • Main= R4,548
  • Main+1= R6,452
  • Max per family= R8,039
Optometry:
  • 1 eye exam, from day-to-day benefit
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.

Wellness/Preventative benefits (2025):

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

Profmed: ProActive Plus Premium
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • Covered
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered
Pap Smear:
  • Covered
Mammogram:
  • Covered, for 40yrs+, every 2 years
PAS Test:
  • Covered
HIV Test:
  • PMBs only
Other:
  • Malaria: R460 per person
  • Tobacco and Alcohol counselling: 2 sessions per family
  • Bone density test: 65yrs+, every 5 years
  • Fecal occult test: 50yrs+
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 Profmed plans, with costs and brief summary.

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Other benefits for 2025:

ProActive Plus Premium
International Insurance:
  • In and Out of hospital emergencies: R2.5 million per person per trip
Other:

    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


What does a “PMBs only” restriction mean?
In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

What does “From Risk” mean?
The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

What is a DSP?
A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover.