Optometry

This benefit includes cover for lenses, frames, contact lenses and eye surgery.

• Optometry consultations from your available day-to-day benefits, subject to the benefit limit on your chosen Option:
  • On Retail Essential Plus Option claims are paid from your available Medical Savings Account and Above Threshold Benefit
  • On Retail Essential Option claims are paid from your overall Out-of-Hospital Benefit, limited to R2 000 for a single member, or R4 050 for the family
• Frames, lenses and contact lenses at 100% of the Scheme Rate from available day-to-day benefits, subject to the benefits of your chosen Option:
  • On the Essential Plus Option, a sub-limit of R6 100 per person per year applies
  • On the Essential Option, we pay for these frames, lenses or contact lenses from your overall Out-of-Hospital Benefit, which is limited to R2 000 for a single member or R4 050 for the family
• Ophthalmology procedures performed in hospital from the in-hospital benefit, up to 100% of the Scheme Rate. This includes cover for corneal cross linking.
• Radial Keratotomy, Excimer laser and refractive eye surgery procedures up to 100% of the Scheme Rate from your available day-to-day benefits, subject to the benefit limit on your chosen Option:
  • On the Essential Plus Option, a sub-limit of R6 100 per person per year is applied
  • On the Essential Option we pay from your overall Out-of-Hospital Benefit, which is limited to R2 000 for a single member, or R4 050 for a family

You can get discounts on frames and lenses

You can get up to 20% off on your frames and eyeglass lenses when you visit an optometrist in the Optometry Network.

The discount is only applicable to hardware items such as frames and eyeglass lenses and excludes contact lenses and professional services (consultation and eye examination fees).

What to do when you pay cash

For cash payments, you get the discount immediately and you pay the amount at the till. Once you have paid, you must submit the proof of payment to us, and we will pay the claimed amount as shown on the invoice, subject to the applicable benefit limits