Bestmed Medical Scheme
Maximise your benefit - Visit an In Network Provider
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, UniqueMedicalAidKey
Example: SMS 45119 Message details: Benefit 277323232 Botha 19721220 7212205065089 0 84
Important information:
Replace each comma with a space in your SMS, 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. The Schemes unique medical aid key is 84.
Beat 3 / Network
2021 Optical Benefit:
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, Forensic protocols and AI screening included in design
The benefits is 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.)
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 825.00 towards an alternative Frame and or Lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 565.00 per beneficiary
- Contact lens re-examination every 6 months after initial consultation
Beat 4
2021 Optical Benefit:
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
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 825.00 towards an alternative Frame and or lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 565.00 per beneficiary
Pace 1
2021 Optical Benefit:
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
One Comprehensive Consultation
- One pair of clear standard: Either Single Vision or Bifocal lenses or Multifocal lenses
- IN NETWORK : A PPN Frame to the value of R 825.00 towards an alternative Frame and or Lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 565.00 per beneficiary
Pace 2
2021 Optical Benefit:
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
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 825.00 towards an alternative Frame and or Lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 565.00 per beneficiary
Pace 3
2021 Optical Benefit:
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
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 825.00 towards an alternative Frame and or lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 565.00 per beneficiary
Pace 4
2021 Optical Benefit
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
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 825.00 towards an alternative Frame and or lens enhancements
- OR
- OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 850.00 per beneficiary
Pulse 1
2021 Optical Benefit
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph or OCT Benefit available for positive pathology, 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.)
One Composite Consultation
One pair of spectacle lenses: Either Single Vision or Bifocal Lenses (Multifocal Lenses paid up to the Bifocal limit)
IN NETWORK : A frame to the value of R 225.00 towards frame and or lens enhancements
OR
OUT OF NETWORK/REFUND VALUE : A Frame to the value of R163.00 towards an alternative Frame and or Lens enhancements
Contact lenses limited to R 630
Pulse 2
2021 Optical Benefit
Each beneficiary is entitled to the following benefits within a 2 year benefit cycle subject to the last claiming date.
Fundus photograph Benefit available for positive pathology, 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.)
One Composite Consultation
One pair of standard spectacle lenses either Single Vision or Bifocal or Multifocal lenses
IN NETWORK : A frame to the value of R 825.00 towards an alternative Frame and Lens enhancements
OR
OUT OF NETWORK/REFUND VALUE : A Frame to the value of R 598.00 towards an alternative Frame and or Lens enhancements
Contact lenses to the value of R 1 565.00
