2019 just got clearer with your Optometry Benefit

Bankmed appointed a new Optometry Benefit Management company, from 1 January 2019 for the Core Saver, Traditional, Comprehensive and Plus Plans.  The Bankmed Optical Management company will extensively monitor utilisation by Healthcare Professionals and members, and manage the optical benefits.

All optical benefits are subject to clinical necessity according to the Optometry Benefit Management Programme and the limits that apply to your Plan.

Benefits are limited to the Scheme Rate for spectacle lenses or contact lenses. You can choose either glass or plastic spectacle lenses.

How it works

Bankmed members receive optometry services and material, like spectacles and contact lenses, at a preferred and discounted rate from any optometrist within the network. You will receive services and items at a guaranteed reduced rate. The Bankmed Optical Management company incorporates 97% of all optometry providers in South Africa, making it more likely that your chosen optometrist is a member of this network. To find an optometrist log in to www.bankmed.co.za > Find a Healthcare Professional. 

Items that may not be covered by Bankmed

Not all items prescribed by your optometrist may be covered. Some of these items include:
 

• Sunglasses and spectacles with a tint exceeding 35%.
• Lens additions and/or luxury (branded) lens add-ons that are not clinically essential. Benefits for extras or lens additions are subject to pre-authorisation.
• New spectacles within a current 24-month clinical period. Motivations for new spectacles within a clinical cycle are carefully scrutinised to ensure that additional benefits may be allowed when the updating of such lenses are clinically required.

Your role

As a better-informed member, you can make a difference to your healthcare costs, so next time you receive eye care keep the following in mind:

• Always confirm your available benefits with the optometrist as well as with Bankmed before you have your consultation. Bankmed will be able to assist you with questions regarding your benefits.
• Make 100% certain of the cost of the items that will not be covered by Bankmed and check with your optometrist why these services and/or materials are necessary.

Should you have any further questions in this regard, please feel free to call Bankmed on 0800 BANKMED (0800 226 5633).