Optometry Benefits

Origin offers the following optometry benefits every two years, subject to an amount of R1550 per beneficiary, subject to the member’s day-to-day benefits.

• 1 Eye test (including refraction, test, and tonometry) at no more than R600 per beneficiary every two years, paid from risk.

Materials / components

• Combined benefit – one pair of spectacles (single vision, bifocal, or base multifocal lenses, including frames) or contact lenses.
• Spectacles or contact lenses (not both).
• Refractive surgery – 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 R1550 per beneficiary, subject to the member’s day-to-day benefits and/or medical savings account (MSA).

• 1 Eye test (including refraction, test, and tonometry) at no more than R600 per beneficiary every two years, paid from risk.

Materials / components

• Combined benefit – one pair of spectacles (single vision, bifocal, or base multifocal lenses, including frames) or contact lenses.
• Spectacles or contact lenses (not both).
• Refractive surgery – 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 and/or medical savings account (MSA).

Silver offers the following optometry benefits every two years, subject to an amount of R2050 per beneficiary, subject to the member’s day-to-day benefits.

• 1 Eye test (including refraction, test, and tonometry) at no more than R600 per beneficiary every two years, paid from risk.

Materials / components

• Combined benefit – one pair of spectacles (single vision, bifocal, or base multifocal lenses, including frames) or contact lenses.
• Spectacles or contact lenses (not both).
• Refractive surgery – 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.

Gold offers the following optometry benefits every two years, subject to an amount of R4100 per beneficiary, subject to the member’s day-to-day benefits and/or medical savings account (MSA).

• 1 Eye test (including refraction, test, and tonometry) included in the combined benefit, subject to day-to-day benefits and/or medical savings account (MSA).

Materials / components

• Combined benefit – one pair of spectacles (single vision, bifocal, or base multifocal lenses, including frames) and/or contact lenses.
• Spectacles and/or contact lenses.
• 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 R6850 per beneficiary, subject to the member’s day-to-day benefits.

• 1 Eye test (including refraction, test, and tonometry) included in the combined benefit, subject to day-to-day benefits

Materials / components

• Combined benefit – one pair of spectacles (single vision, bifocal, or base multifocal lenses, including frames) and/or contact lenses.
• Spectacles and/or contact lenses.
• Refracture surgery, an amount of R26080 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.