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 30
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 30.
2021 Optical Benefits:
Each beneficiary is entitled to the following benefits within a 2 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.)
All co-payments on the optical benefit are subject to available Savings.
Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply
One Comprehensive Consultation
- One pair of clear standard lenses: Either Single Vision or Bifocal lenses or Multifocal lenses
- IN NETWORK : A Frame to the value of R 1 350.00 towards an alternative Frame and or Lens enhancements
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 979.00 towards an alternative Frame and or Lens enhancements
- 1 x ReadyMade Readers at R150 per pair (Part of Spectacle Lens benefit)
- Contact lenses to the value of R 1 935.00
- A contact lens re-examination every 6 months after the composite consultation