Sizwe Medical Fund


Sizwe Medical Fund

Affordable Plan:

Optical benefits managed by PPN (Preferred Provider Negotiators). Choose either spectacles (frames and lenses) or contact lenses once every 2 years

Eye Test:

% Benefit

Limit


100% Sizwe Rate

1 test per beneficiary every 2 year

Combined Frames and Lenses:

% Benefit 


100% Sizwe Rates            Sub-Limits

Member                             R1 570


Member +1                        R1 680

Member +2                        R1 900

Member +3                        R2 020

Member +4                        R2 080

Member +5                        R2 130

Member +6+                      R 2 190



Multi-focal/Varifocal Lenses: 

Sub-limit

R680 per lens subject to annual limit

Contact Lenses 

% Benefit 

Limit 

1 pair of permanent contact lenses every 2 years or 12 pairs of monthly disposable contact lenses per beneficiary per year.

100% Sizwe Rate

Included in above

Refractive Surgery, including Radial Keratotomy:

% Benefit 

Limit  


100% Sizwe Rate

R5 620 per family per year



Gomomo Plan:

Choose either spectacles (frames and lenses) or contact lenses once every 2 years 



% Benefit 


Limit


Sub-limits


Eye Test  100% Sizwe Rates  1 test per beneficiary every 2 years 
Combined Frames and Lenses  100% Sizwe Rates 

Member R1010     

Member+1-R1161

Member+2-

Member+3+ 

R1 290 


Frame limit 
R465 per beneficiary every 2 years 

Savings Care Plan:

Optical benefits managed by PPN (Preferred Provider Negotiators) Choose either spectacles (frames and lenses) or contact lenses once every 2 years


% Benefit  Limit 
Eye Test 100% Sizwe Rate 1 test per beneficiary every 2 years, subject to available saving
Combined Frames and Lenses  100% Sizwe Rates  1 per beneficiary every 2 years, subject to available saving
Contact lenses 100% Sizwe Rates  Included in above limit, subject to available saving
Refractive surgery and Radial Keratotomy 
No Benefits 

Full Benefit Plan:

Optical benefits managed by PPN (Preferred Provider Negotiators) Choose either spectacles (frames and lenses) or contact lenses once every 2 years


% Benefit 

Limit  Sub-limits
Eye Test Eye Test  100% Sizwe Rate 1 test per beneficiary every 2 years 
Combined Frames and Lenses  100% Sizwe Rates 

Member R2 360

Member+1 R2 470

Member+2 R2 810

Member+3 R2 920

Member+4 R3 030

Member+5 R3 150 Member+6+ R3 200

Multi-focal/Varifocal Lenses

R680 per lens subject to annual limit 
Contact lenses  100% Sizwe Rates  Included in above limit  1 pair of permanent contact lenses every 2 years or 12 pairs of monthly disposable contact lenses per beneficiary per year
Refractive Surgery, including Radial Keratotomy  100% Sizwe Rates  R10 790 per family per year


Primary Care Plan:

Optical benefits managed by PPN (Preferred Provider Negotiators) Choose either spectacles (frames and lenses) or contact lenses once every 2 years


% Benefit Limit  Sub-limit 
Eye Test  100% Sizwe Rates   1 test per beneficiary every 2 years 
Combined Frames and Lenses  100% Sizwe Rates 

Member R1 120

Member+1 R1 240

Member+2 R1 290

Member+3 R1 350

Member+4 R1 460

Member+5 R1 570 Member+6+ R1 630

Multi-focal/Varifocal Lenses  

R450 per lens subject to annual limit 
Contact lenses  100% Sizwe Rates  Included in above limit 


This summary is for information purposes only and does not supercede the rules of the Fund. In the event of any discrepancies between this benefit brochure and the scheme rules, the Rules will prevail. For a copy of the rules please go visit www.sizwe.co.za or call us on 0860 10 08 71



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