Optometry Benefits

Origin offers the following optometry benefits every two years, subject to an amount of R1 490 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 R525
• 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 offers the following optometry benefits every two years, subject to an amount of R1 490 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 R525
• 1 pair of lenses (clear single vision)
• Contact lenses valued at R730 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 offers the following optometry benefits every two years, subject to an amount of R1 975 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 R660
• 1 pair of lenses (clear single vision)
• Contact lenses valued at R885 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 offers the following optometry benefits every two years, subject to an amount of R3 950 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 260
• 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
• Contact lenses valued at R1 870 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 offers the following optometry benefits every two years, subject to an amount of R6 600 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 975
• 1 pair of lenses (clear single vision or clear bifocal lenses or clear multifocal lenses)
• Contact lenses valued at R3 060 per beneficiary per 12-month period
• Spectacles and contact lenses
• Refracture surgery, an amount of R25 100 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.