Bestmed Medical Scheme
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Beat 3 / Network
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 500.00 per beneficiary
- Contact lens re-examination every 6 months after initial consultation
Beat 4
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 500.00 per beneficiary
Pace 1
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 500.00 per beneficiary
Pace 2
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 500.00 per beneficiary
Pace 3
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 500.00 per beneficiary
Pace 4
2020 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 578.00 towards an alternative Frame and or Lens enhancements
- Contact lenses: R 1 790.00 per beneficiary
Pulse 1
2020 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 R150.00 towards an alternative Frame and or Lens enhancements
Contact lenses limited to R 600
Pulse 2
2020 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 578.00 towards an alternative Frame and or Lens enhancements
Contact lenses to the value of R 1 500.00
