Note: We are updating 2024 benefits as they are released. Some plans show old benefits until schemes release new plans.

Bestmed Beat 1 Network:in-and-out of hospital benefits (2024)


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Monthly Costs:

Beat 1 Network 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R1,873
  • R1,456
  • R789
  • 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
Note:
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
  • All treatments and procedures are subject to authorisation and protocols
  • All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️
Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

You can also:
♦️Compare any two plans, side by side | ♦️View all the Bestmed plans, with costs and brief summary
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In-hospital Procedures for 2024:

Bestmed: Beat 1 Network
Assume scheme pays all these costs, unless otherwise stated
non-Network Specialists:
  • 100% scheme rate
network Specialists:
  • 100% scheme rate
non-Network GPs:
  • 100% scheme rate
network GPs:
  • 100% scheme rate
Hospital Choice:
  • Long stay:: Network hospital
  • Day Procedure: Day network
Day Hospitals:
  • Day procedures at DSP: scheme rate.
  • If the provider is a DSP and does not work in a day hospital, the procedure will be Covered in full if it is done in an acute hospital.
Penalty for using other hospital:
  • non-Network hospital: R13,732 co-payment
  • non-DSP Day hospitals: R2,625 co-payment
Other Co-payments:
    Specialised Radiology:
    • MRI, CT scans, isotope studies: Scheme rate
    Supplementary Services: (Physio, etc)
    • 100% scheme rate
    Transplants:
    • PMBs only
    Dialysis:
    • Covered, in and out of hospital
    Exclusions:
    • Joint replacement surgery
    • Dental and Oral surgery
    Alternatives to hospitals:
    • Alternatives to hospitalisation: 100% scheme rate
    • Palliative Care or at-home care, in lieu of hospitalisation: R66,591 per person
    Casualty:
    • PMBs only
    Other: .
    Note:
    • 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
    ♦️View all the other benefits for this plan:♦️
    Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

    You can also:
    ♦️Compare any two plans, side by side | ♦️View all the Bestmed plans, with costs and brief summary
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    Out-of-hospital Procedures for 2024:

    Bestmed: Beat 1 Network
    Assume scheme pays all these costs, unless otherwise stated
    Summary of day-to-day benefits:
    Main Member: Adult: Child:
    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.
    PMBs out of hospital:
    • All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
    • This can include consults with specialists, blood or other tests, radiology and medicine
    • The benefit is paid by the scheme, and not out of your savings account
    • If you have no day-to-day funds, you still have cover for PMBs
    • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
    • See our Guide to PMBs for more information.
    General info:
    • This plan has no savings fund, so most out of hospital costs are paid by you
    • You can access the free Tempo program and unlock some out of hospital benefits
    GP consultations:
    • PMBs only
    Childcare:
    • Ages 0-2 years: 3 baby growth and development assessments per year
    Specialists consultations:
    • PMBs only
    Pathology:
    • PMBs only
    General radiology:
    • PMBs only
    Specialised radiology:
    • MRI, CT Scan, isotope studies: R6,179 per family
    • Excludes PET scans
    Supplementary Services: (Physio, etc)
    • PMBs only
    General Appliances:
    • Out of hospital: No benefit
    • In-hospital: 100% scheme rate
    1.1. Hearing Aids:
    • No benefit
    1.2. Wheelchairs:
    • No benefit
    Note:
    • PMBs: Prescribed Minimum Benefits. To read more about PMBs click 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
    ♦️View all the other benefits for this plan:♦️
    Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

    You can also:
    ♦️Compare any two plans, side by side | ♦️View all the Bestmed plans, with costs and brief summary
    .

    All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

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    Medication Benefit for 2024:

    Bestmed: Beat 1 Network
    Assume scheme pays all these costs, unless otherwise stated
    Summary of day-to-day benefits:
    Main Member: Adult: Child:
    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.
    Chronic:
    • Also covers Depression
    • If you voluntarily use medicine that is not on Bestmed's list (formulary), you pay a 30% co-payment
    Acute (presrcibed) medication:
    • No benefit
    Over-the-counter:
    • No benefit
    Birth Control:
    • R2,678 per person
    On Discharge:
    • 7 days
    Biological:
    • In-hospital: R11,099 per family, unless part of PMB-protocol
    • Out-of-hospital: PMBs only
    Note:
    • Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
    • Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
    • PMBs: Prescribed Minimum Benfits. To read more about PMBs click 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
    ♦️View all the other benefits for this plan:♦️
    Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics

    You can also:
    ♦️Compare any two plans, side by side | ♦️View all the Bestmed plans, with costs and brief summary
    .

    All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.


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