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Optometry Benefits

The range of benefits available differ on our various healthcare options.

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OptiClear manages beneficiaries’ optical benefits on behalf of the Scheme.

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Benefits across the Scheme’s healthcare options

  • Eye examinations
  • Visual aids, including spectacles, frames, single vision, multifocal lenses, and contact lenses
  • Eye surgery

ORIGIN

Origin offers the following optometry benefits every two years, subject to an amount of R1425 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R500
  • 1 pair of lenses (clear single vision)
  • Contact lenses – no benefits


How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

EQUILIBRIUM

Equilibrium offers the following optometry benefits every two years, subject to an amount of R1425 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R500
  • 1 pair of lenses (clear single vision)
  • Contact lenses valued at R700 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)


How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

SILVER

Silver offers the following optometry benefits every two years, subject to an amount of R1890 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R630
  • 1 pair of lenses (clear single vision)
  • Contact lenses valued at R845 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)


How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

GOLD

Gold offers the following optometry benefits every two years, subject to an amount of R3780 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R1200
  • 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
  • Contact lenses valued at R1790 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)


Refracture surgery, subject to pre-authorisation and overall optical benefits.

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits and/or medical savings account (MSA).

PLATINUM

  • Platinum offers the following optometry benefits every two years, subject to an amount of R6300 per beneficiary, subject to the member’s day-to-day benefits
  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R1890
  • 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
  • Contact lenses valued at R2930 per beneficiary per 12-month period
    • Spectacles and contact lenses


Refracture surgery, an amount of R24000 per beneficiary once per lifetime, subject to pre-authorisation.

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits, self-funding gap and threshold zone.

Optometry Benefits

ORIGIN

Origin offers the following optometry benefits every two years, subject to an amount of R1 425 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R500
  • 1 pair of lenses (clear single vision)
  • Contact lenses – no benefits

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

Optometry Benefits

EQUILIBRIUM

Equilibrium offers the following optometry benefits every two years, subject to an amount of R1 425 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R500
  • 1 pair of lenses (clear single vision)
  • Contact lenses valued at R700 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

Optometry Benefits

SILVER

Silver offers the following optometry benefits every two years, subject to an amount of R1 890 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R630
  • 1 pair of lenses (clear single vision)
  • Contact lenses valued at R845 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits.

Optometry Benefits

GOLD

Gold offers the following optometry benefits every two years, subject to an amount of R3 780 per beneficiary, subject to the member’s day-to-day benefits.

  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R1 200
  • 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
  • Contact lenses valued at R1 790 per beneficiary per 12-month period
    • Spectacles or contact lenses (not both)

Refracture surgery, subject to pre-authorisation and overall optical benefits.

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits and/or medical savings account (MSA).

Optometry Benefits

PLATINUM

  • Platinum offers the following optometry benefits every two years, subject to an amount of R6 300 per beneficiary, subject to the member’s day-to-day benefits
  • 1 Eye test (including refraction, test and tonometry)
  • 1 frame valued at not more than R1 890
  • 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
  • Contact lenses valued at R2 930 per beneficiary per 12-month period
    • Spectacles and contact lenses

Refracture surgery, an amount of R24 000 per beneficiary once per lifetime, subject to pre-authorisation.

How much a member can spend on each of the above will depend on the amount of money the member has available in their day-to-day benefits, self-funding gap and threshold zone.

Thinking of using your optical benefits?

Click on LIVE CHAT to chat to us online, download the KeyHealth mobile app to see your statements, or contact the Client Service centre on 0860671050.

You can also contact Opticlear to confirm your available benefits:

  • Email: opticlear@optics.co.za
  • Phone: (011)4616337 or (021)6803823
  • Fax: 0865191569