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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

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 0 121

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 121.

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

Find your nearest PPN optometrist

Try on a PPN Frame

To begin, simply browse to, and upload a photo of yourself look directly ahead (Just like the examples above)

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