Bestmed Beat 1 Network:prosthetic benefits (2024)

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

We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative

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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

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Prosthetics benefits (2024):

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

Bestmed: Beat 1 Network
Overal Limit:
  • Internal: R91,183 per family
  • External: PMBs only
Prosthetics required for PMB conditions are always paid paid in full by scheme, with no co-payment, if you follow the protocols. More info here
Sub-limits: (per person):
  • Functional (treating or supporting a bodily function): R32,550
  • Vascular: R52,500
  • Pacemaker, dual chamber: R49,711
  • Spinal: R36,394
  • Mesh: R12,772
  • Gynaecology/Urology: R10,437
  • Drug eluting stents: PMBs and DSP products only
  • Lens implants: R7,964 per lens
    Exclusions:
  • Endovascular and catheter-based procedures
  • Joint replacements, unless PMB
    PMB joint replacements - prosthesis limits:
  • Hip replacement and other major joints: R38,313
  • Knee replacement: R47,240
  • Minor Joints: R14,695
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
♦️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
.
.
.
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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