Sizwe Value Platinum Core:
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 Sizwe Value Platinum Core View all the Sizwe 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)

Sizwe:Value Platinum Core (2025 prices)
Main member: Adult member: Child member:
Total Cost pm:
  • R5,306
  • R5,082
  • R1,353
  • Only pay for 3 children
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R2345
  • R1986
  • R512
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • 6197
  • 3645
  • 1585
Children Rates:
  • Up to age 26
  • Only pay for 3 children
Income band:

Dentistry benefits (2025):

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

Sizwe: Value Platinum Core
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R2345
  • R1986
  • R512
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • 6197
  • 3645
  • 1585
Standard Dentistry:
  • 2 consults per person
  • Fillings, extractions, oral hygiene, root canal: Covered
  • Plastic dentures: one set per beneficiary every 4 years
  • From day to day benefit
Specialised Dentistry:
  • Crowns & Bridgework, Dentures, Orthodontics, removal of impacted wisdom teeth and non-surgical)
  • Crowns: one crown per family
  • Implant: R17,199 per person, every 5 years
  • Metal Dentures: 2 frames per person, one person per year
  • Paid by scheme
In-Hospital Dentistry:
  • Children under 7yrs: Paid by scheme
  • Impacted wisdom teeth: Covered as day case
  • Maxillo facial surgery: 100% scheme rate
Orthodontics:
  • Paid by scheme, up to 21yrs old

Optometry benefits (2025):

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

Sizwe: Value Platinum Core
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R2345
  • R1986
  • R512
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • 6197
  • 3645
  • 1585
Optometry:
LimitFrom day to day benefit
Consult:1 test per person every 2 years
Frames:R1,175
Single lensesR247 per lens
Bifocals:R537 per lens
MultifocalsR985 per lens
ContactsR2,128 per person
Refractive Surgery:R8,440
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)

Sizwe: Value Platinum Core
Assume scheme pays all these costs, unless otherwise stated
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • Covered, for 65yrs+
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered, up to age 12m
Pap Smear:
  • Covered for 18yrs+,
Mammogram:
  • Covered for 40yrs+, every year
PAS Test:
  • Covered for 40yrs+
HIV Test:
  • Covered
Other:
  • Bone density test: Covered, 50yrs+
View other benefits for this plan:
In-hospital | Out-of-hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

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Other benefits for 2025:

Value Platinum Core
International Insurance:
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.