Overview
Bestmed, known for its commitment to personalized health care services, offers a range of medical aid options tailored to meet the diverse needs of its members. This includes specialized eye care benefits, ensuring that your vision health is in good hands.
In this guide, we’ll explore the various optometrist network plans provided by Bestmed, highlighting the key features, eligibility criteria, and benefits of each. Whether you require regular eye examinations, prescription glasses, or more specialized ocular treatment, Bestmed’s network plans are structured to offer optimal coverage and peace of mind.
What is a medical scheme optometry network?
By establishing a system of pre-approved optometrists and eye care facilities, medical aid schemes’ optometry network plans aim to make quality eye care more inexpensive and accessible to members. Comprehensive health care plans include these policies, which aim to improve and maintain eye health and vision.
As such, medical aid optometry network plans serve the following purposes:
- ✅ These plans typically cover a range of optometric services including eye exams, vision tests, prescriptions for glasses and contact lenses, and sometimes treatments for common eye conditions.
- ✅ By negotiating rates with a network of optometrists, medical aid schemes can offer these services at lower or subsidized costs. This makes eye care more affordable for members and helps manage the overall cost of health benefits.
- ✅ Regular eye exams can detect early signs of eye conditions such as glaucoma, cataracts, and macular degeneration, leading to early intervention and better management of potential vision problems.
- ✅ Optometrists in the network are typically vetted to ensure they meet certain standards of care, providing members with access to qualified professionals.
Network optometry plans can typically be used for the following reasons:
Routine Examinations
Members use these plans for annual or biannual eye exams to check for vision changes and eye health, crucial for updating prescriptions and catching early signs of eye disease.
Corrective Lenses
These plans often cover part or all of the cost of glasses or contact lenses, making corrective eyewear more affordable.
Specialized Services
For more specific eye issues, such as dry eye syndrome or diabetic retinopathy, network plans may cover consultations and treatments with eye care specialists.
Emergency Care
Some plans include provisions for urgent care related to eye injuries or sudden vision loss, ensuring prompt treatment.
Optometry network plans are a valuable part medical aid schemes, improving their healthcare offering by providing necessary eye care services that might otherwise be inaccessible or unaffordable for many individuals.
⚠️ Read more about the Best Medical Aids that cover Vision Health
When to Choose Network Plans
When deciding whether an optometry network plan is suitable for your specific eye care needs, there are several factors you should consider:
Coverage Details
- ✅ Check if the plan covers routine eye examinations and how often you can have them.
- ✅ Check whether the plan includes coverage for prescription glasses and contact lenses, including limits on the frequency of replacements.
- ✅ Find out if treatments for specific eye conditions, such as glaucoma or cataracts, are covered.
- ✅ See if corrective surgeries, such as LASIK, are included if you might consider this option in the future.
Network Size and Quality
- ✅ Look at the size and distribution of the network to ensure there are qualified optometrists and eye care centres near you.
- ✅ Investigate the qualifications and reputation of the providers in the network to ensure high-quality care.
Cost
- ✅ Consider how much you will pay for the network plan and compare it with the potential out-of-pocket costs for similar services outside the network.
- ✅ Check for any co-payment or deductible requirements and how they might affect your overall costs.
- ✅ Check if there is a cap on out-of-pocket expenses, which can be crucial for managing costs in case of extensive treatments.
Flexibility
- ✅ Consider whether are restricted to network providers or if you can also see out-of-network optometrists, albeit possibly at a higher cost.
- ✅ Look for any limitations or exclusions in the plan, such as denial of coverage for certain conditions or treatments.
Family Needs
- ✅ If you have a family, check whether the plan covers dependents and the specific terms related to their care.
- ✅ Consider the specific needs of your family members, such as paediatric eye care or specialized treatments for chronic conditions.
Bestmed Network Optometrists
These are the steps you need to take on the Bestmed website to look for optometry network providers:
1. Go to the webpage for Bestmed.
2. Click on “Members” in the menu.
3. Find “Provider Search” or “Network Providers” on the list.
4. Choose “Optometry Providers” from the list of groups.
5. You can narrow down your search by adding your city or province to find providers in your area.
Using the app:
✅Open the Bestmed app.
✅Go to the “Network Providers” section.
✅Choose “Optometry Providers”.
✅Type in your address to look for optometry providers in your area.
Bestmed Plans with Network Optometrists
Bestmed offers various medical aid plans with optometry benefits that are accessible through their network of providers:
Pace1 Plan
✅ Benefits available every 24 months from
date of service.
✅Network Provider
• Consultation – One (1) per beneficiary.
• Frame = R1 000 covered AND
• 100% of cost of standard lenses
(single vision OR bifocal OR multifocal)
OR
• Contact lenses = R1 840 OR
✅ Out of Network Provider
• Consultation – R365 fee at nonnetwork provider
• Frame = R750 AND
• Single vision lenses = R215 OR
• Bifocal lenses = R460 OR
• Multifocal lenses = R982.50
Contact lenses, limited to R1 840
Rhythm2 Plan
✅ Network Provider: Includes one consultation per beneficiary, with frame coverage up to R245 and coverage for standard lenses
Single vision lenses =From R215
Bifocal lenses = From R460
Multifocal lenses = From R460
Contact Lenses limited to R700
✅Out-of-network and casualty visits.
Out-of-network visits to an FP and casualty
visits are limited to a maximum of R1 647 per
family per year.
Beat2 Plan
- ✅Use savings account
Optometry Network Exceptions
Bestmed members can choose to use non-network optometrists under certain conditions:
Emergencies
If an emergency situation arises where immediate optometric care is needed and a network provider is not available, members can visit a non-network optometrist.
Lack of Availability
If there is non-network provider available or if the network providers cannot accommodate the member within a reasonable time frame, the member may opt for a non-network provider.
Voluntary Choice
Members have the choice to voluntarily use non-network providers, but should be aware that this might lead to higher out-of-pocket expenses since these providers may charge fees higher than what the scheme covers.
Conclusion
Affordability and availability to high-quality eye treatment are greatly enhanced by the optometrist network plans provided by Bestmed medical aid scheme. These plans make sure that members get thorough eye exams, affordable corrective lenses, and important vision care by utilizing a network of skilled optometrists.
Plans offered by Bestmed’s optometry network improve visual health and general wellness by focusing on preventative care and the early diagnosis of eye diseases. Members can rest easy knowing that these plans will take care of their eye care needs, which in turn promotes better health and a more positive outlook on life.
