Bestmed Beat 1:
prosthetic benefits (2025)

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This page has information on: Costs and Prosthetics for Bestmed Beat 1

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Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2025)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bestmed:Beat 1 (2025 prices)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,347
  • R1,822
  • R987
  • Only pay for 3 children
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:
  • Under 24 unless registered student, then under 26
  • Only pay for 3 children

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bestmed:Beat 1 (2026 prices)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,523
  • R1,959
  • R1061
  • Only pay for 3 children
Savings (per year):
  • No savings account option on this plan
  • The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:
  • Under 24 unless registered student, then under 26
  • Only pay for 3 children

Prosthetics benefits (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bestmed: Beat 1
Overal Limit:
  • Internal: R99,764 per family
  • External: PMBs only
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Sub-limits: (per person):
  • Functional (treating or supporting a bodily function): R35,613
  • Vascular: R57,441
  • Pacemaker, dual chamber: R54,390
  • Spinal: R39,819
  • Mesh: R13,975
  • Gynaecology/Urology: R11,419
  • Drug eluting stents: PMBs and DSP products only
  • Lens implants: R8,713 per lens
    Exclusions:
  • Joint replacements, unless PMB
    PMB joint replacements - prosthesis limits:
  • Hip replacement and other major joints: R41,918
  • Knee replacement: R51,686
  • Minor Joints: R16,078
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Note:
  • PMBs: Prescribed Minimum Benfits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here.
  • DSPs: Designated Service Provders. Where stipulated, you must use specific specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product
Always consult with your broker before making final decisions regarding your healthcare cover.

    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • "Unlimited" benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised
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What does a “PMBs only” restriction mean?
In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

What does “From Risk” mean?
The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

What is a DSP?
A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover. 

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