Bestmed Rhythm 1 A:
in-and-out of hospital benefits (2025)

What's on this page:

This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bestmed Rhythm1 A.

Monthly Costs (2025)

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

Rhythm 1 A 2025 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R1,615
  • R1,615
  • R665
  • Pay for all 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
  • Pay for all children
Income band:
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:
In-hospital | 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.

Find all other open medical aid plans here.
.

In-hospital Procedures (2025):

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

Bestmed: Rhythm 1 A
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
non-Network Specialists:
  • 100% scheme rate
Scheme rate is set by Bestmed
network Specialists:
  • 100% scheme rate
non-Network GPs:
  • 100% scheme rate
network GPs:
  • 100% scheme rate
Hospital Choice:
  • Long stay:: Network hospital
  • Day Procedure: Day network
Day Hospitals:
  • PMBs only, except for below
  • R54,915 per family
  • Voluntary use of acute hospital instead of a day hospital: R2,746 co-payment
  • If your DSP does not work in a day hospital, the scheme will cover full cost for acute hospital, if authorised first
    • Circumcision
    • Colonoscopy, R2,000 co-payment
    • Female and male sterilisation
    • Gastroscopy, R2,000 co-payment
    • Grommet insertion and myringotomy
    • Tonsillectomy
Penalty for using other hospital:
  • Use of non--Network hospital: R14,364 penalty
  • Voluntary use of acute hospital instead of a day hospital: R2,746 penalty
  • If your DSP does not work in a day hospital, the scheme will cover full cost for acute hospital, if authorised first
 You don't pay a penalty if admission was unavoidable due an emergency
Other Co-payments:
  • Colonoscopies: R2,000 co-payment
  • Gastroscopies: R2,000 co-payment
 * There might be other co-payments if you don't use scheme-chosen provider for some services.

* Treatment required for PMB level care is always paid by scheme, with no co-payment, if you follow the protocols.
That means that these co-payments might not apply in your case! More info here
Specialised Radiology:
  • MRI, CT scans, isotope studies: PMBs only
No limits or co-payments for PMB level care and/or for emergency
Scopes:
  • Colonoscopy and Gastroscopy: part of R54,915 per family limit, with a R2,000 co-payment
  • See "Day Hospitals" for more detail
 No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • 100% scheme rate
No limits or co-payments for PMB level care and/or for emergency
Transplants:
  • PMBs only
Dialysis:
  • PMBs only
Exclusions: Exclusions:
  • All non-PMB procedures, except those below. See Day Hospital benefit for more detail.
    • Circumcision
    • Colonoscopy
    • Female and male sterilisation
    • Gastroscopy
    • Grommet insertion and myringotomy
    • Tonsillectomy

  • Note: All schemes have extensive exclusions. We've tried to list the major ones here, but please consult your scheme or broker to get the full list.
 * Treatment required for PMB level of care is always paid by scheme, if you follow the protocols. It cannot be excluded. More info here.

Alternatives to hospitals:
  • Alternatives to hospitalisation: PMBs only
  • Palliative Care or at-home care, in lieu of hospitalisation: PMBs only
Casualty:
  • PMBs only

Other: .
Note:
  • 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 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:
In-hospital | 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.

Find all other open medical aid plans here.
.

Out-of-hospital Procedures (2025):

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

Bestmed: Rhythm 1 A
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
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.
PMBs out of hospital:
  • All medical aids must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine
  • The benefit is paid by the scheme, and not out of your savings account
  • If you have no day-to-day funds, you still have cover for PMBs
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
General info:
  • This plan does not have a savings fund, but a lot of out of hospital costs are paid by Bestmed, if you use their network providers
  • You can access the free Tempo program and unlock some out of hospital benefits
GP consultations:
  • Network GP: Unlimited
 Treatment required for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Childcare:
  • Ages 0-2 years: 3 baby growth and development assessments per year
  • Immunisations: Covered
Specialists consultations:
  • Must be referred by network provider
  • R2,553 per family
Treatment required for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Pathology:
  • Scheme pays for basic blood tests
General radiology:
  • Basic X-rays as requested by network provider.
Specialised radiology:
  • PMBs only
Scans required for PMB level care are paid paid by scheme, with no co-payment, if you follow the protocols. More info here
Scopes:
  • Colonoscopy and Gastroscopy: part of R54,915 per family limit, with a R2,000 co-payment
  • See "Day Hospitals" for more detail
 No limits or co-payments for PMB level care and/or for emergency
Supplementary Services: (Physio, etc)
  • PMBs only
General Appliances:
  • Out of hospital: No benefit
  • In-hospital: PMBs only
1.1. Hearing Aids:
  • No benefit
1.2. Wheelchairs:
  • No benefit
Note:
  • PMBs: Prescribed Minimum Benefits. To read more about PMBs click 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:
In-hospital | 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.

Find all other open medical aid plans here.
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

Medication Benefit (2025):

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

Bestmed: Rhythm 1 A
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
Main Member: Adult: Child:
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.
Chronic:
  • If you voluntarily use medicine that is not on Bestmed's list ("formulary"), you pay a 30% co-payment
 You might be required to use specific pharmacies and be limited to specific medicines
Acute (presrcibed) medication:
  • Paid by Bestmed if on medicine list
Over-the-counter:
  • R240 per family
Birth Control:
  • R2,000 per person
  • IUD insertion: once every 5 years
On Discharge:
  • 7 days if part of hospital account
  • R150 if from pharmacy, on day of discharge
Biological:
  • PMBs only
 Treatment that is required (by law) for PMB conditions is always paid paid by scheme, with no co-payment, if you follow the protocols. More info here.)
Note:
  • Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
  • Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
  • PMBs: Prescribed Minimum Benfits. To read more about PMBs click 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:
In-hospital | 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.

Find all other open medical aid plans here.
.

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.


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