Doctor Visits

10 per year, only at the Fund’s clinics or at contracted  panel doctors


Dentures may only be made at contracted panel dentists and with the prior approval of the Fund.

  • The Fund will pay 80% of the costs
  • The member will pay 20% of the costs

A Beneficiary is entitled to a set of dentures once every five years

Hospital Benefit: State hospital:

The member can claim up to R1800 per year for the following medical expenses:

  • Hospital cost
  • Medic Alert bracelet (one per beneficiary)
  • Ambulance cost
Maternity Benefit:

A Beneficiary may claim any costs for antenatal, maternity and post-natal care provided that such care is obtained through state or provincial hospitals to a maximum of R300 per member per year.

Dental Services:

R700 can be claimed for the following:

  • Teeth extractions
  • Teeth fillings
  • Oral hygiene
  • Repair of dentures


Optical Benefits:

Spectacles may only be made at contracted panel optometrists and with the prior approval of the Fund.

The Fund will pay for:

  • Testing of the member’s eyes (once every two years)
  • Normal clear lenses
  • Bifocal lenses ( reading glasses )
  • R500 to the cost of the spectacle frame

The member will pay for:

  • Balance of spectacle frame charges
  • Tinted / colour (photochromatic) lenses, unless as otherwise agreed between the Fund and the contracted service provider.

A Beneficiary who has claimed a pair of spectacles may only claim again after two years.

Chronic Medication:

Treatment and medication for chronic conditions in terms of the Rules of the Fund.