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OptiClear requires all Claims to have Valid Prescriptions and Icd10 codes
All Claims will be subject to a Clinical Validation Process (clinical necessity) and certain Services and Materials may require a motivation.
Benefit confirmation is required via the Call Centre on 0861 OPTICS (678427)
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| KEYHEALTH 2012 | |  |
Benefits are limited to either Spectacles OR Contact lenses on the Gold and Silver options
Benefits payable according to OptiClear Tariff and Discount
No Benefits for Sunglasses (tint >35%)
Silver option (Subject to Overall Limit R 950 every 2 years)
- Benefits only available from Opticlear Network Provider
- 1 Eye Test every 2 years
- 1 Frame every 2 years (R 320)
- 1 Pair of White Single Vision Generic lenses every 2 years
- No Add ons
- Contact Lenses: R 420 per year
Gold option (Subject to Overall limit R 1900 every 2 years)
- 1 Eye Test every 2 years
- 1 Frame every 2 years (R 600)
- 1 Pair Generic lenses every 2 years
- Add on: Generic Tariff for Photochromatic tint or Fixed tint < 35%
- Contact Lenses: R 900 per year
Platinum option (Subject to Overall limit R 3200 every 2 years)
Spectacles and Contact lenses
- 1 Eye Test every 2 years
- 1 Frame every 2 years (R 950)
- 1 Pair Generic lenses every 2 years
- Add on: Generic Tariff for Photochromatic tint or Fixed tint < 35%
- Contact Lenses: R 1500 per year
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| PROFMED 2012 | |  |
Benefits are limited to either Spectacles OR Contact lenses
Benefits payable according to OptiClear Tariff and Discount
No Benefits for Sunglasses (tint >35%)
ProSecure/ Plus option (Subject to Day-to-Day Limit)
- 1 Eye Test every 2 years
- 1 Frame every 2 years (R 650)
- 1 Pair Generic lenses every 2 years
- Contact Lenses: R 1290 every 2 years
Pro Pinnacle option (Subject to Day-to-Day Limit)
- 1 Eye Test every 2 years
- 1 Frame every 2 years (R 900)
- 1 Pair Generic lenses every 2 years
- Add on: Generic Tariff for Anti Reflex Coating
- Contact Lenses: R 2200 every 2 years
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| SCHEMES ADMINISTERED BY METROPOLITAN 2012 | | ![]() |
Benefits payable according to OptiClear Tariff
No Benefits for Sunglasses (tint >35%)
Netcare
(For Benefits, Please phone the Metropolitan Call Centre)
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| SCHEMES ADMINISTERED BY MMSA 2012 | |  |
Benefits payable according to OptiClear Tariff
No Benefits for Sunglasses (tint >35%)
Momentum Health
(For Benefits, Please phone the MMSA Call Centre on 0860 11 7859 )
SAB Medical Aid Society
(For Benefits, Please phone the MMSA Call Centre on 0860 00 2133 )
Moto Health Care
(For Benefits, Please phone the MMSA Call Centre on 0861 00 0300 )
Bepmeds
(For Benefits, Please phone the MMSA Call Centre on 0860 10 2903 )
Nampak SA Medical Scheme
(For Benefits, Please phone the MMSA Call Centre on 0860 10 1047)
Alliance Midmed
(For Benefits, Please phone the MMSA Call Centre on 0860 00 2101 )
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