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Sizwe Medical Fund

Maximise your benefit - Visit an In Network Provider

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

Gold Ascend & Gold Ascend Network

2020 Optical Benefits (old Primary/Primary Select):

Beneficiaries are only entitled to claim once every 24 months as of the Date of Service

PPN 1 tariff applicable  (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.)

Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply

One Composite Consultation

A value of R 579 towards an alternative frame and or lens enhancements together with one pair of clear lenses:

Single Vision or Bifocal lenses (Multifocals covered up to the Bifocal limit)

Specific Tints and Coatings are covered up to the frame limit specified.

Contact lenses are limited to R 1 337.00

Strict protocols are written for contact lenses and all Hard lenses must be motivated.

Platinum Enhanced & Network option

2020 Optical Benefits (Old  Affordable Option):

PPN 1 Tariff Applicable (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.)

Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply

Beneficiaries are entitled to claim once every 24 months as of the Date of Service

One Composite Consultation

A Frame to the value of R 884.00 towards a frame and or lens enhancements together with one pair of lenses:

Single vision lenses or Bifocal lenses or Multifocal lenses

Specific Tints & Coatings are covered up to the frame limit

Contact lenses are subject to R 1 663.00  per cycle

Strict script limitations are placed on contact lenses and Hard contact lenses must be motivated

Titanium Executive

2020 Optical Benefits (old Full Care):

PPN 1 Tariff Applicable  (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.)

Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply

Beneficiaries are entitled to claim once every 24 months as of the Date of Service

One composite consultation

A value of R 1 116.00 towards a frame and or lens enhancements together with one pair of lenses:

Single vision lenses or Bifocal lenses or Multifocal lenses

Specific Tints & Coatings are covered up to the frame limit

Contact lenses to the value of R 1 884.00

Specific script limitations must be met and hard contact lenses must be motivated

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Try on a PPN Frame

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