Optometry Benefits

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.

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.

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.

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).

• 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.