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Moto Health Care

Maximise your benefit - Visit an In Network Provider

Your benefits are contractually better at a network provider - Scheme rules apply

To confirm that you or a dependent is entitled to optical benefit, SMS your request to 45119 with the following details:

Benefit,MembershipNumber,Surname,BirthDateDependent,MainMemberID,DependantNumber, UniqueMedicalAid Key

Example: SMS 45119 Message details: Benefit 277323232 Botha 19721220 7212205065089 0 79

Important information:

Replace each comma with a space in your SMS and ensure the details are accurate and only one space is between each requirement. Kindly make sure the birthdate is in the correct format as per the example. The information will return within 1 minute on a new SMS. The full benefit breakdown per dependent is available by logging in to the PPN website or a guideline is given below. Your schemes unique medical key is 79.

Classic / Classic Network

2022 Optical Benefit:

Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Member can claim either Spectacles OR Contact Lenses
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)

Benefits are subject to Overall Annual Savings

Overall Savings Limits:  Please confirm on website or with agent

PPN clears and make payment on accounts. Momentum provide remittances to Members directly

Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350

(Available on annually)

  • NETWORK/OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 860
AND
  • One pair of either Single Vision or Bifocal or Multifocal clear standard lenses

(The Above limits are all subject to the availability of the Annual Savings as per the description)

Contact lenses: R 1 530 per beneficiary per annum

Hospicare / Hospicare Network

2022 Optical Benefits:

PPN clears and forwards the claim to Medical aid for tax purposes

Member will not pay more than the Negotiated PPN 1 tariff at an IN NETWORK provider

The PPN tariff is up to 77% lower than the industry tariff

PMB Insured Optical Benefits adjudicated by PPN.

In Network : Consultation at Scheme rate

Out of Network: Consultation at Industry rate

Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes

In Network : Spectacles at Scheme rate

Out of Network: Spectacles at Industry rate

Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes

In Network : Contact Lenses at Scheme rate

Out of Network: Contact lenses at Industry rate

Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes

Optimum Option

2022 Optical Benefits:

Each beneficiary is entitled to the following benefits within a two year benefit cycle from last date of claiming.

Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)

Benefits are subject to Day to Day limits

Member can claim either Spectacles OR Contact Lenses

Forensic protocols and AI screening included in design

Day to Day Limits: Please confirm on website or with agent

PPN clears and make payment on accounts. Momentum provide remittances to Members directly

Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350

  • NETWORK/OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 1 355
AND
  • One pair of either Single Vision or Bifocal or Multifocal clear standard lenses

(The Above limits are all subject to the availability of the Day to Day limit as per the description)

Contact lenses: R 2 280 per beneficiary per annum subject to available Day to Day limit

Find your nearest PPN optometrist