The short version
- Optometry is not a Prescribed Minimum Benefit. Routine eye tests, frames and lenses are only covered if your specific option publishes an optical benefit.
- Cataract surgery and treatment of eye disease are a different matter — those are in-hospital or PMB benefits and are covered on every registered option, usually subject to a co-payment and pre-authorisation.
- Most schemes route optical claims through a contracted network. Using an optometrist outside that network typically means paying the difference yourself.
- Optical benefits are usually granted per beneficiary on a two-year cycle, not annually.
Computed from 2026 plan data
Cheapest option with a day-to-day pool
Bonitas BonCapR1 730 a month, with a published day-to-day benefit of R2 390 a year for a single member.
Computed from published 2026 contributions and brochure figures. Not financial advice.
What the 2026 brochures say
Verbatim mentions from each scheme's own 2026 brochure summary.
Glasses or contact lenses are available through the contracted service provider once every 2 years
1 eye test per beneficiary at a network provider
1 eye test per beneficiary at a network provider
One eye test at a network optometrist with an upfront payment of R130 for the test
One eye test at a network optometrist with an upfront payment of R130 for the test
Basic GP, acute medicine, optical, dental & radiology
R3,000 optometry per beneficiary
107 of 114 plans in our 2026 data don't mention this in the brochure summary we hold. That doesn't mean they exclude it — check the plan's own brochure.
Where our data stops
Our structured 2026 data set carries contributions, hospital, chronic, day-to-day and maternity fields. It does not yet carry a typed rand optical sub-limit per plan, because the scheme brochures publish those in benefit tables we have not extracted field-by-field. We therefore show verbatim brochure statements only, and never estimate a frame or lens limit.
Questions people ask
Does medical aid pay for glasses in South Africa?
Only if your specific option publishes an optical benefit. Hospital-only plans generally do not pay for frames or lenses at all. Savings and comprehensive options usually do, either from your medical savings account or from a capped optical benefit granted every two years through a contracted optometry network.
Is an eye test covered by medical aid?
On plans with an optical benefit, one eye test per beneficiary per benefit cycle is typically covered in full at a network optometrist. On hospital plans it is normally out of pocket.
Is cataract surgery covered?
Yes. Cataract surgery is an in-hospital procedure covered on registered medical scheme options, but several schemes apply a specific co-payment to it and require pre-authorisation and use of a designated provider. Check the plan page for the co-payment published for 2026.
How often can I claim for new glasses?
Most South African schemes work on a 24-month optical cycle per beneficiary rather than a calendar year. Confirm the cycle with the scheme, because it typically runs from your last claim date, not from January.
Related on Medical Aid Online
Sources
This guide is general information, not financial or medical advice. Medical Aid Online is not a medical scheme. Scheme rules and benefits change every year, so check the scheme's own rules and brochure before you decide.
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