Medical Aid member

Contracted Medical Aids


BENEFIT REQUIRED CODE MAXIMA
Entry Saver
Saver
Advanced
MAXIMA
Plus
Exec
Standard/Elec
ULTIMAX MAXIMA
BASIS
BLUE DOOR
Submission Medscheme Medscheme Medscheme Medscheme Iso Leso

SAVINGS CLAIMS

SAVINGS CLAIMS

Family Limit

n/a

R 9 700

Refer Medscheme

R 13 800

incl Dentist

Medscheme

n/a

n/a

Beneficiary Limit

 

R 3 180

R 6 900 incl Dentist

Vision Examination

(Iso Leso Members)

11001/11081

R 525

R 525

R 525

Bronze Benefit

Bronze Benefit

PEP Providers

(Iso Leso Members)

01PEP

R 100

R 100

R 100

Bronze Benefit

Bronze Benefit

Vision Examination

(Non-Iso Leso Members)

11001/11081

R 405

R 405

R 405

Bronze Benefit

Bronze Benefit

Single Vision Lenses

(Glass/Plastic)

71BS001/72BS001

81BS001/82BS001

R 262

R 262

R 262

Bronze Benefit

Bronze Benefit

Accommodation

Support Lenses*

83BS001

R 565

R 565

R 565

Bronze Benefit

Bronze Benefit

Bifocal Lenses**

(Glass/Plastic)

74BS001

84BS001

R 635,50

R 635,50

R 635,50

Bronze Benefit

Bronze Benefit

Multifocal Lenses**

(Glass/Plastic

85BS001

86BS001

R 797

R 797

R 797

Bronze Benefit

Bronze Benefit

Multifocal Lenses**

(Glass/Plastic)

76BS001

R 1039

R 1039

R 1039

Bronze Benefit

Bronze Benefit

Frames

40501

R 1 500

Included, Limit to R193

Included, Limit to R193

*Accom Support Lens for age <40years require motivation

** Bifocal and Multifocal Lens for age <40years require motivation

OR

Contact Lens Materials

Per plan

Per plan

Bronze Benefit

Bronze Benefit

PATIENT TO PAY

Lens Enhancements

All Lens Codes

Optical Assistant

Med Aid

Optical Assistant

Med Aid

Optical Assistant

Med Aid

Optical