• Bestmed

Bestmed Rhythm 1 C:
in-and-out of hospital benefits (2026)

Contents:

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bestmed Rhythm1 C. Please consult and verify with the scheme or your broker for full benefits, and an explanation of all the "fine print".

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:Rhythm 1 C (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R3,615
  • R3,615
  • R1873
Savings:
  • 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 24yrs.
  • Pay for all children
Income band:
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In-hospital Procedures (2026):

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

Bestmed: Rhythm 1 C
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:
  • 100% scheme rate
Gap Cover:
Can push payout up to 700% scheme rate
(Plans coming soon)
Hospital Choice:
  • Long procedure: Network hospital
  • Day Procedure: Network day hospital
Penalty for using other hospital:
  • Use of non-network hospital: R15,025 penalty
  • Voluntary use of long stay hospital instead of a day hospital: R2,872 penalty
  • If your DSP does not work in a day hospital, the scheme will cover full cost for acute hospital, if authorised first
 Gap Cover:
Can cover the penalty in full
(Plans coming soon)
Co-payments:
  • Colonoscopies: R2,000 co-payment
  • Gastroscopies: R2,000 co-payment
Note:
  • If you use a DSP (designated service provider), you never have to pay a co-payment for protocol treatment of a PMB (Prescribed Minimum Benefit). More info here
  • There might be other co-payments, especially if you don't use a DSP for a PMB or when buying medicine.
 Gap Cover:
Can cover most co-payments
(Plans coming soon)
Specialised Radiology:
  • MRI, CT scans, isotope studies: PMBs only
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • Colonoscopy and Gastroscopy: part of R57,441 per family limit, with a R2,000 co-payment, unless PMB
  • See "Day Hospitals" for more detail
 Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • 100% scheme rate
Transplants:
  • PMBs only
Dialysis:
  • PMBs only
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
  • NB: See scheme's rules for all exclusions. All schemes have plenty!
 Gap Cover:
Coming soon
Alternatives to hospitals:
  • Alternatives to hospitalisation: PMBs only
  • Palliative Care or at-home care, in lieu of hospitalisation: PMBs only
Casualty/ER:
  • PMBs only
Gap Cover:
Can cover ER claims
(Plans coming soon)
Other: .
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

Out-of-hospital Procedures (2026):

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

Bestmed: Rhythm 1 C
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
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.
Other Day-to-Day Funds:
PMBs out of hospital:
  • All schemes 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.
  • PMB benefits must never be paid from your savings account.
  • 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.
GP consultations:
  • Network GP: Unlimited
Childcare:
  • Ages 0-2 years: 3 baby growth and development assessments per year
  • Immunisations: Covered
 Gap Cover:
Can pay for child ER visits
(Plans coming soon)
Specialist consultations:
  • Must be referred by network provider
  • R2,670 per family
Pathology:
  • Scheme pays for basic blood tests
General radiology:
  • Basic X-rays as requested by network provider.
Specialised radiology:
  • PMBs only
Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Scopes:
  • Colonoscopy and Gastroscopy: part of R57,441 per family limit, with a R2,000 co-payment, unless PMB
  • See "Day Hospitals" for more detail
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
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
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

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 (2026):

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

Bestmed: Rhythm 1 C
Assume scheme pays all these costs, unless otherwise stated
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.
Other Day-to-Day Funds:
Chronic:
Acute (prescribed) medication:
  • Paid by Bestmed if on medicine list
Over-the-counter:
  • R251 per family
Birth Control:
  • Oral/Injectable/Implantable: R2,092 per person
  • IUD: R3,295 per person, every 5 years
On Discharge:
  • 7 days if part of hospital account
  • R450 if from pharmacy, on day of discharge
Biological:
  • PMBs only
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

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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