Bestmed Pace 1:prosthetic benefits (2024)

This page has information on: Costs and Prosthetics for Bestmed Pace 1 We also have information for: In-hospital, Out of hospital, Medicine, Dentistry, Optometry, Maternity, Cancer, Mental Health, Other/Extra Benefits and Wellness and Preventative Find all the open medical aid plans here. Compare any two plans side by side, instantly. Monthly Costs: Pace 1 2024 prices Main member: Adult member: Child member: Total Cost pm: R5,061 R3,555 R1277 Only pay for 3 children Savings: R11,544 R8,100 R2,916 Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R12,607 Main+1= R25,213 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 . You'll get the printable guide as well as a weekly newsletter 🙂 Prosthetics benefits (2024): (Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics) Bestmed: Pace 1 Overal Limit: Overall: R104,366 per family External: R26,504 per family, as sublimit of above 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: R64,955 Spinal: R38,038 Mesh: R14,282 Gynaecology/Urology: R10,299 Lens implants: R7,828 per lens Drug eluting stents: PMBs and DSP products only Exclusions: Endovascular and catheter-based procedures Joint replacements, unless PMB PMB joint replacements - prosthesis limits: Hip replacement and other major joints: R38,725 Knee replacement: R51,497 Minor Joints: R15,999 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