Remedi
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 78
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 78.
Comprehensive
2022 Optical Benefits:
Annual cycle : Optical benefit subject to the Beneficiary limit of R 3595
Beneficiary limit subject to available Family limit of R 7 190
PPN clears and pays insured portion / Discovery pays members directly and make payment out of savings (where applicable)
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.)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R365
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 1 765
- OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 1 325
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Benefit subject to available beneficiary/family limits
Contact lenses: R 2 390 per beneficiary
Benefit subject to available beneficiary/family limits
Remedi Classic
2022 Optical Benefits:
Negotiated Tariff : PPN1 (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.)
Annual cycle : Optical benefit subject to the Beneficiary limit of R 3 385
Beneficiary limit subject to available Family limit of R 6 770
Full benefit subject to available IOH (Insured Out of Hospital) benefit available
PPN clears and pays insured portion subject to response from DH / Discovery pays members (where applicable)
Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R365
- Frame and Lens Enhancement benefit up to the value of R 1 115
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Benefit subject to available beneficiary/family/IOH limits
Contact lenses: R 1 930 per beneficiary
Benefit subject to available beneficiary/family/IOH limits
Standard
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.)
NO BENEFITS OUT OF NETWORK ON THIS OPTION
One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 315
- REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 236
- One pair of either Single Vision or Bifocal standard lenses
Contact lenses: R 595 per beneficiary
- Comprehensive
- Remedi Classic
- Standard
