Bestmed Beat 4:

prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Bestmed Beat 4

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 4 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R6,059
  • R5,004
  • R1,498
  • Only pay for 3 children
Savings:
  • R10,176
  • R8,412
  • R2,520
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R14,831
  • Main+1= R29,661
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 4
Overal Limit:
  • R112,478 per family
  • External: R27,053 per family
  • External benefit includes artificial limbs, limited to 1 limb every 60 months
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): R35,700
  • Vascular: R68,250
  • Pacemaker, dual chamber: R65,092
  • Spinal: R38,864
  • Mesh: R14,420
  • Gynaecology/Urology: R10,575
  • Drug eluting stents: R21,835
  • Lens implants: R8,239 per lens
    Exclusions:
  • Endovascular and catheter-based procedures
  • Joint replacements, unless PMB
    PMB joint replacements - prosthesis limits:
  • Hip replacement and other major joints: R39,962
  • Knee replacement: R53,090
  • Minor Joints: R16,313
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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