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
Assume scheme pays all these costs, unless otherwise stated
Optometry:
Limit
Consult:
1 test per person every 2 years
Frames:
R300
Single lenses
R210 per lens
Bifocals:
R445 per lens
Multifocals
R445 per lens
Contacts
R645 per person
Refractive Surgery:
No 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.
