• Bestmed

Bestmed Pace 1:
prosthetic benefits (2026)

Contents:

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

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 Providers. Where stipulated, you must use 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 (2026)

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

Bestmed: Pace 1 (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R5,934
  • R4,289
  • R1541
Savings:
  • R13,524
  • R9,780
  • R3,516
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R13,794
  • Main+1= R27,586
Children Rates:
  • Under 24yrs.
  • Only pay for 3 children
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Prosthetics benefits (2026):

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

Bestmed: Pace 1
Assume scheme pays all these costs, unless otherwise stated
Overall Limit:
  • Overall: R114,189 per family
  • External: R28,998 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 in full by scheme, with no co-payment, if you follow the protocols. More info here
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Sub-limits: (per person):
  • Functional (treating or supporting a bodily function): R39,060
  • Vascular: R74,674
  • Pacemaker, dual chamber: R71,068
  • Spinal: R41,618
  • Mesh: R15,626
  • Gynaecology/Urology: R11,269
  • Lens implants: R8,565 per lens
  • Drug eluting stents: Vascular prosthetic limit
    Exclusions:
  • Endovascular and catheter-based procedures
  • Joint replacements, unless PMB
    PMB joint replacements - prosthesis limits:
  • Hip replacement and other major joints: R42,369
  • Knee replacement: R56,344
  • Minor Joints: R17,505
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Note:
  • PMBs: Prescribed Minimum Benefits. PMBs cannot have sublimits or co-payments if protocols are followed. You can read more about PMBs here.
  • DSPs: Designated Service Providers. Where stipulated, you must use 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.
    Important!
  • Unless specified, assume that all benefits 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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