• Bestmed

Bestmed Pace 4:
full prosthetic benefits (2026)

Contents:

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

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 4 (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R12,572
  • R12,572
  • R2,945
Savings:
  • R4,524
  • R4,524
  • R1056
Extended Fund:
Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account
  • Main= R45,375
  • Main+1= R73,172
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 4
Assume scheme pays all these costs, unless otherwise stated
Overall Limit:
  • Overall: R170,081 per family
  • External: R39,216 per family
  • 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): R45,953
  • Vascular: R79,269
  • Pacemaker, dual chamber: R79,255
  • Spinal, including artificial disk: R79,255
  • Drug-eluting stent: R85,048
  • Mesh: R24,942
  • Gynaecology/Urology: R20,584
  • Lens implants: R22,792 per lens
  • Hip replacement/prosthesis and other major joints: R76,102
  • Knee prosthesis: R88,120
  • Minor joints: R28,323
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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