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Sizwe Platinum Enhanced EDO:
dentistry, optometry and wellness (2024)

This page has information on: Costs, Dentistry , Optometry Wellness and Preventative and Other benefits for Sizwe Platinum Enhanced EDO

We also have information on: In-hospital, Out of Hospital, Medicine, Maternity, Cancer, Mental Health and Prosthetics benefits.

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Monthly Costs:

Platinum Enhanced EDO 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R4,511
  • R4,511
  • R1149
  • Only pay for 3 children
Savings:
  • R12144
  • R11628
  • R3084
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R11,362
  • Main+1= R16,287
  • Main+2= R18,740
  • Main+3= R20,392
  • Main+4= R22,855
  • Main+5= R25,329
  • Main+6+= R27,639
Children Rates:
  • Child rates up to age 25. Grandchildren included.
  • Only pay for 3 children
Income band:
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 Sizwe plans, with costs and brief summary
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Dentistry benefits (2021):

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

Sizwe: Platinum Enhanced EDO
Assume scheme pays all these costs, unless otherwise stated
Standard Dentistry:
  • 2 general checkups per person
  • Root canal: not on wisdom or primary teeth
  • Plastic Dentures: 1 set, full or partial per person every 4 years
  • Fillings: coverec
  • Intra-oral x-ray: from protocols
  • Extra-oral: 1 per person, every 3 years
Specialised Dentistry:
  • Crowns: 1 crown per family
  • Implants: No benefit
  • Metal dentures:2 partial frames per person, every 5 years. One per family per year
In-Hospital Dentistry:
  • Children under 5yrs: Covered
  • R1,000 co-payment for day clinic admission
  • General anaesthetic benefits for impacted teeth. IV conscious sedation benefits for in-room procedures
 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:
  • 9-18yrs only, with a 35% co-payment
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 Sizwe plans, with costs and brief summary
.
.
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Optometry benefits (2021):

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

Sizwe: Platinum Enhanced EDO
Assume scheme pays all these costs, unless otherwise stated
Optometry:
Consult:1 test per person every 2 years
Frames:R884 per person
Single lensesR185 per lens
Bifocals:R420 per lens
MultifocalsR420 per lens
ContactsR1,663 with guidelines
Refractive Surgery:R7,010 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 Sizwe plans, with costs and brief summary
.
.
.

Wellness/Preventative benefits (2021):

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

Sizwe: Platinum Enhanced EDO
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • R284 per person and R2,242 per family
  • Shared with: screening tests, vaccines
Pneumonia vaccines:
  • R284 per person and R2,242 per family
  • Shared with: screening tests, vaccines
Biometric Screening:
  • R284 per person and R2,242 per family
  • Shared with: screening tests, vaccines
Child Immunisation:
  • R284 per person and R2,242 per family
  • Shared with: screening tests, vaccines
Pap Smear:
  • Covered for 21yrs+, every 2 years
Mammogram:
  • Covered for 40yrs+, every 2 years
PAS Test:
  • Covered for 40yrs+
HIV Test:
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 Sizwe plans, with costs and brief summary
.
.
.

Other benefits for 2021:

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

Platinum Enhanced EDO
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 Sizwe 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

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