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In line with our philosophy of encouraging members to pursue a healthier and active lifestyle, we’ve developed a set of preventative care benefits that entitles you to a number of screenings, preventative tests and vaccines.
| BENEFIT |
QUANTITY AND FREQUENCY |
BENEFIT CRITERIA | BEAT | PACE | PULSE |
| Flu vaccines | 1 per beneficiary per year | Applicable to all active members and beneficiaries | √ | √ | √ |
| Pneumonia vaccines | Children: As per schedule of Department of Health Adults: Twice in a lifetime with booster above 65 years of age |
The Scheme will identify high-risk individuals for immunisation | √ | √ | √ |
| Travel vaccines | Quantity and frequency dependent on | Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera from Scheme risk benefits |
*Available on Beat2, Beat3 and Beat4 | √ | √ |
| Paediatric immunisation | According to the Bestmed vaccine schedule | *Available on Beat2, Beat3 and Beat4 | √ | √ | |
| Female contraceptives | Quantity and frequency dependent on product and subject to maximum amount Mirena - 1 device every 60 months |
Limited to R2 315 per beneficiary per year | √ | √ | √ |
| Back and neck preventative programme | Subject to pre-authorisation | Preferred providers (DBC/ Workability Clinics) | √ | √ | √ |
| Mammogram | Females 40 years and older. Once every 24 months | Scheme tariff applies | *Available on Beat2, Beat3 and Beat4 | √ |
√ (tariff code 34100) |
| HPV vaccinations | 3 vaccinations per beneficiary. Females 9 - 26 years | Vaccinations funded at MRP | √ | √ | √ |
| PSA screening | Males 50 years and older. Once every 24 months | Can be done at a urologist or GP. Consultation paid from the available savings/consultation benefit | *Available on Beat2, Beat3 and Beat4 | √ | X |
| Bone densitometry | Beneficiaries 45 years and older. Once every 24 months | X | *Available on Pace2, Pace3 and Pace4 | X | |
| Pap smear | 18 years and older. Once every 24 months | At any gynaecologist or GP. Consultation is paid from available savings or consultation benefit | √ | √ | X |
| Preventative dentistry | Dependent on the type of procedure required | Subject to pre-authorisation, clinical protocols and funding guidelines | *Available on Beat2, Beat3 and Beat4 | √ | X |
The Pulse range offers preventative services under the basic and specialised dentistry benefit. Benefits mentioned above may be subject to pre-authorisation, clinical protocols, formularies, funding guidelines and the Mediscor Reference Price (MRP).
| DESCRIPTION OF SERVICE | AGE | FREQUENCY | BEAT | PACE | PULSE |
| General full-mouth examination by a general dentist (incl. gloves and use of sterile equipment for the visit) | 12 years and above
Under 12 years |
Once a year
Twice a year |
√ *Available on Beat2, Beat3 and Beat4 |
√√ |
X X |
| Full-mouth intra-oral radiographs | All ages | Once every 36 months |
√ *Available on Beat2, Beat3 and Beat4 |
√ | √ |
| Intra-oral radiographs | All ages | 2 photos per year |
√ *Available on Beat2, Beat3 and Beat4 |
√ | X |
| Scaling and/or polishing | All ages | Twice a year |
√ *Available on Beat2, Beat3 and Beat4 |
√ | X |
| Fluoride treatment | All ages | Twice a year |
√ *Available on Beat2, Beat3 and Beat4 |
√ | X |
| Fissure sealing | Up to and including 21 years | In accordance with accepted protocols |
√ *Available on Beat2, Beat3 and Beat4 |
√ | X |
| Space maintainers | During primary and mixed denture stage | Once per space |
√ *Available on Beat2, Beat3 and Beat4 |
√ | X |
*Subject to pre-authorisation, clinical protocols and funding guidelines.
Note:The Pulse range offers preventive services under the basic and specialised dentistry benefit.
