Optical
HIGH COVER LEVEL 1
BONITAS
2021
BonComprehensive
BESTMED
2021
Pace 3
DISCOVERY
2021
Classic Comprehensive
FEDHEALTH
2021
MaximaExec
MEDIHELP
2021
Plus
MOMENTUM
2021
Extender –
Any Hospital,
Any Chronic
Subject to Savings and ATB. Limit to R3,330 per beneficiary. PPN. Sub-limits apply
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings and Threshold. DEB limit of R6,180 per beneficiary before and after threshold
Subject to Savings/ Wallet or self-funded and Threshold. R3,600 pbpa, R11,000 pfpa. Limits apply before and after Threshold.
Optical Screening for children age 5 – 8 years – 1 per lifetime is covered from risk
Benefits pb per 24 months and subject to PPN Network. 1 consultation, signle vision/bi-focal/multi-focal lenses, limit of R1,000 (PPN frames) and/or lens enhancements OR R1,680 contact lenses
Subject to available Savings & Threshold (Extender Cover limit of R4,300 pb, sub-limit of R2,350 for frames)
HIGH COVER LEVEL 2
BONITAS
2021
BonClassic
BESTMED
2021
Page
DISCOVERY
2021
Essential Comprehensive
FEDHEALTH
MEDIHELP
2021
Elite
MOMENTUM
2021
Extender: Any (Chronic: Any)
R5,845 per family (every 2 years). Subject to the use of a PPN. Sub-limit per beneficiary: 1 eye test or R350 at a non-DSP. Lenses covered 100% at network rates or R185 (single vision), R445 (bifocal), R770 (multifocal) per lens at non-DSP. Frames R1,110 at DSP, R805 at non-DSP. Contact lenses R1,880
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings and Threshold. DEB limit of R6,180 per beneficiary before and after threshold
Benefits pb per 24 months and subject to PPN Network. 1 consultation, signle vision/bi-focal/multi-focal lenses, limit of R1,000 (PPN frames) and/or lens enhancements OR R1,680 contact lenses
Subject to available Savings & Threshold (Extender Cover limit of R4,300 pb, sub-limit of R2,350 for frames)
MEDIUM-HIGH LEVEL 1 COVER
BONITAS
2021
BonComplete
BESTMED
2021
Pace 1
DISCOVERY
2021
Classic Priority
FEDHEALTH
MEDIHELP
MOMENTUM
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to Savings and ATB: PPN. Sub- limits apply
Subject to available Savings and Threshold . DEB limit of R5,610 per beneficiary before and after threshold
MEDIUM-HIGH LEVEL 2 COVER
BONITAS
2021
Standard
BESTMED
2021
Pace 1
DISCOVERY
2021
Classic Priority
FEDHEALTH
2021
FlexiFed 4 Any Hospital
MEDIHELP
2021
Prime 3
MOMENTUM
2021
Incentive:
Any Hospital, Any Chronic
R6,430 per family (every 2 years). Subject to the use of a PPN. Sub-limit per beneficiary: 1 eye test or R350 at a non-DSP. Lenses covered 100% at network rates or R210 (single vision), R445 (bifocal), R770 (multifocal) per lens at non-DSP. Frames R1,275 at DSP, R924 at non-DSP. Contact lenses R1,965
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings and Threshold . DEB limit of R5,610 per beneficiary before and after threshold
Subject to Savings/ Wallet or self-funded and Threshold. R3,600 pbpa, R11,000 pfpa. Limits apply before and after Threshold.
Optical Screening for children age 5 – 8 years – 1 per lifetime is covered from risk
Benefits pb per 24 months and subject to PPN Network. 1 consultation, signle vision/bi-focal/multi-focal lenses, limit of R800 (PPN frames) and/or lens enhancements OR R1,200 contact lenses
Subject to Savings, if available
MEDIUM-HIGH LEVEL 3 COVER
BONITAS
2021
Standard Select
BESTMED
2021
Pace 1
DISCOVERY
2021
Essential Delta Comprehensive
FEDHEALTH
2021
FlexiFed 4 GRID
MEDIHELP
2021
Prime 3 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
R6,430 per family (every 2 years). Subject to the use of a PPN. Sub-limit per beneficiary: 1 eye test or R350 at a non-DSP. Lenses covered 100% at network rates or R210 (single vision), R445 (bifocal), R770 (multifocal) per lens at non-DSP. Frames R1,275 at DSP, R924 at non-DSP. Contact lenses R1,965
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings and Threshold. DEB limit of R6,180 per beneficiary before and after threshold
Subject to Savings/ Wallet or self-funded and Threshold. R3,600 pbpa, R11,000 pfpa. Limits apply before and after Threshold.
Optical Screening for children age 5 – 8 years – 1 per lifetime is covered from risk
Benefits pb per 24 months and subject to PPN Network. 1 consultation, signle vision/bi-focal/multi-focal lenses, limit of R800 (PPN frames) and/or lens enhancements OR R1,200 contact lenses
Subject to Savings, if available
MEDIUM-LOW COVER 1
BONITAS
2021
BonSave
BESTMED
2021
Beat 3
DISCOVERY
2021
Classic Saver, Coastal Saver & Classic Delta Saver
FEDHEALTH
2021
Unify
MEDIHELP
2021
Prime 3 (Network)
MOMENTUM
2021
Incentive – Any Hospital, Associated Chronic
Subject to Savings. PPN
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings
Subject to Savings/ Wallet or self-funded. Benefits directly from risk up to the value of R1,860 pb every 2yrs: 1 consultation, 1 pair of single vision or bifocal lenses
Subject to Savings
Subject to Savings, if available
MEDIUM-LOW COVER 2
BONITAS
2021
Primary
BESTMED
2021
Beat 2
DISCOVERY
2021
Essential Saver
FEDHEALTH
2021
FlexiFed 2 Any Hospital
MEDIHELP
2021
Prime 2
MOMENTUM
2021
Incentive – Any Hospital, Associated Chronic
R4,955 per family (every 2 years). Subject to the use of a PPN. Sub-limit per beneficiary: 1 eye test or R350 at a non-DSP. Lenses covered 100% at network rates or R210 (single vision), R445 (bifocal), R770 (multifocal) per lens at non-DSP. Frames R525 at DSP, R381 at non-DSP. Contact lenses R1,295
Subject to Savings
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
MEDIUM-LOW COVER 3
BONITAS
2021
Primary Select
BESTMED
2021
Beat 2 Network
DISCOVERY
2021
Essential Delta Saver
FEDHEALTH
2021
FlexiFed 2 GRID
MEDIHELP
2021
Prime 2 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
R4,955 per family (every 2 years). Subject to the use of a PPN. Sub-limit per beneficiary: 1 eye test or R350 at a non-DSP. Lenses covered 100% at network rates or R210 (single vision), R445 (bifocal), R770 (multifocal) per lens at non-DSP. Frames R525 at DSP, R381 at non-DSP. Contact lenses R1,295
Subject to Savings
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
MEDIUM-LOW COVER 4
BONITAS
2021
BonFit Select
BESTMED
2021
Beat 3 Network
DISCOVERY
2021
Essential Delta Saver
FEDHEALTH
2021
FlexiFed 3 GRID
MEDIHELP
2021
Prime 2 Network
MOMENTUM
2021
Incentive – Associated Hospital, Associated Chronic
Subject to Savings. PPN
Subject to PPN Provider. Consultation R350, Frame R598, Single vision lenses R210 / bifocal lenses R445 /multifocal lenses R770, Contacts R1,565
Subject to available Savings
Subject to Savings/ Wallet or self-funded. Benefits directly from risk up to the value of R1,860 pb every 2yrs: 1 consultation, 1 pair of single vision or bifocal lenses
Subject to Savings
Subject to Savings, if available
HOSPITAL COVER 1
BONITAS
2021
Hospital Standard
BESTMED
2021
Beat 1
DISCOVERY
2021
Essential Core
FEDHEALTH
MEDIHELP
MOMENTUM
2021
Custom – Any Hospital, Associated Chronic
No Benefit
No Benefit
No Benefit
Subject to Health Saver, if available
HOSPITAL COVER 2
BONITAS
2021
Bon-Essential
BESTMED
2021
Beat 1
DISCOVERY
2021
Essential Core
FEDHEALTH
MEDIHELP
Custom – Any Hospital, Associated Chronic
MOMENTUM
2021
Prime
No Benefit
No Benefit
No Benefit
Subject to Day-to-Day Benefits
Subject to Health Saver, if available
HOSPITAL COVER 3
BONITAS
2021
Bon-Essential Select
BESTMED
2021
Beat 1 Network
DISCOVERY
2021
Essential Delta Core & Coastal Core
FEDHEALTH
FlexiFed 1 Network Hospitals
MEDIHELP
Custom – Associated Hospital, Associated Chronic
MOMENTUM
2021
Prime 1 Network
No Benefit
No Benefit
No Benefit
Subject to Savings/ Wallet or self-funded
No Benefit
Subject to Health Saver, if available
Primary Care Network
BONITAS
2021
BonCap
BESTMED
2021
Pulse 1
DISCOVERY
2021
KeyCare Plus
FEDHEALTH
MyFed
MEDIHELP
Ingwe Network
MOMENTUM
2021
Necesse Network
Subject to the use of a PPN. Managed Care protocols apply. 1 eye test or R350 per beneficiary at a non-DSP. Lenses covered 100% at network rates or R210 (single vision), R445 (bifocal), R770 (multifocal) per lens for out of network. Frames R225 pb at network provider, R163 at non-network provider. Contact lenses R1,140 pb
Subject to PPN Provider. 1 Consultation, Frame R225, Single vision lenses R210 / bifocal lenses R445, contact lenses R630, 100% cost of standard lenses at network provider
One eye test pbpa. A specific range of glasses to choose from, or a set of contact lenses every 2 years per beneficiary
DSP: KeyCare Optometry Network
Subject to ISO Leso. 1 consultation. Frame limit of R220 or R220 of any other frame. 1 pair of single vision clear CR39 lenses or 1 pair of bifocal clear CR39 lenses. Benefit available pb every 2yrs
Benefits pb per 24 months and subject to use of PPN Network: 1 eye test, 1 pair clear single vision/ bifocal/ multifocal lenses, R550 (PPN frame) and/or lens enhancements, OR R750 contact lenses
Primary Care Network facility: 1 eye test, 1 pair of clear standard or bi-focal lenses with standard frame pbp2a (min 0.5 refractive measurement to qualify)