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24h Emergency: 084 124 | General Contact: 0860 002 378

Beat2

Plan Details

Hospital & Emergencies

Accommodation (hospital stay) and theatre fees

100% Scheme tariff.  DSP specialist network applicable if the network option is chosen.

Take-home medicine

100% Scheme tariff Limited to 7 days’ medicine

Biological medicine during hospitalisation

Limited to R15 855 per family per annum. Subject to pre-authorisation and funding guidelines.

Treatment in mental health clinic

100% scheme tariff Limited to 21 days per beneficiary

Treatment of chemical and substance abuse

100% Scheme tariff Limited to 21 days or R35 573 per beneficiary. Subject to network facilities.

Consultations and procedures

100% Scheme tariff.

Surgical procedures and anaesthetics

100% Scheme tariff.

Organ transplants

100% Scheme tariff. (Only PMBs.)

Major medical maxillo-facial surgery strictly related to certain conditions

PMBs only at DSP day hospitals.

Dental and oral surgery (In- or out of hospital)

PMBs only at DSP day hospitals. Beneficiaries 7 years and younger - Limited to R5 782 per family. Beneficiaries over 7 years - Dental surgical procedures paid from savings for procedures performed in the doctor’s rooms only.

Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)

100% Scheme tariff Limited to R86 841 per family.

Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit *Functional: Item utilised towards treating or supporting a bodily function.

Sub-limits per beneficiary:
  *Functional R31 000   Pacemaker (dual chamber) R47 344   Vascular R50 000   Endovascular and catheter-based procedures - no benefit   Spinal incl. artificial disk R34 661   Drug-eluting stents - PMBs and DSP products only   Mesh R12 164   Gynaecology/Urology R9 940   Lens implants R7 585 a lens per eye

Prosthesis – External

No benefit (PMBs only).

Exclusions Limits and co-payments applicable. Preferred provider network available.

Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
Hip replacement and other major joints R36 489
Knee replacement R44 990
Other minor joints R13 995

Orthopaedic and medical appliances

100% Scheme tariff.

Pathology

100% Scheme tariff.

Basic radiology

100% Scheme tariff.

Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans only included as indicated per option)

100% Scheme tariff

Oncology

100% Scheme tariff Subject to pre-authorisation. DSP applies.

Peritoneal dialysis and haemodialysis

100% Scheme tariff Subject to pre-authorisation and DSPs

Confinements (Birthing)

100% Scheme tariff.

Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)

PMBs only.

HIV/AIDS

100% Scheme tariff. Subject to pre-authorisation and DSPs

Midwife-assisted births

100% Scheme tariff

Supplementary services

100% Scheme tariff.

Alternatives to hospitalisation

100% Scheme tariff

Palliative care and Home-based care in lieu of hospitalisation

100% Scheme tariff Limited to R63 420 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.

Day procedures at a day-hospital facility

Day procedures at DSPs and/or day hospitals will be funded at 100% network or Scheme tariffs. Voluntary use of non-DSP specialists and acute hospitals will result in a co-payment of R2 500.

International travel cover

Leisure Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 90 days, with R3 million for a family i.e. member and dependants.
Business Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 45 days, with R3 million for a family i.e. member and dependants. 

Co-payments

Co-payment for voluntary use of non-network hospital R13 078 for Beat2 Network option.

Day-to-Day

FP and Specialist consultations

Savings account.

Basic and specialised dentistry

Basic: Preventative benefit or savings account.
Specialised: Savings account.
Orthodontic: Subject to pre-authorisation.

Medical aids, apparatus and appliances

Savings account.

Hearing aids

Subject to pre-authorisation. Savings account.

Supplementary services

Savings account.

Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)

100% Scheme tariff. Limited to R 3 885 per family.

Optometry benefit

Savings account.

Basic radiology and pathology

Savings account.

Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. Excluding PET scans)

100% Scheme tariff. Limited to R5 885 per family.

Oncology

Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.

HIV/AIDS

100% Scheme tariff. Subject to pre-authorisation and DSPs.

Peritoneal dialysis and haemodialysis

100% Scheme tariff. Subject to pre-authorisation and DSPs.

Rehabilitation services after trauma

PMBs only. Subject to pre-authorisation and DSPs.

Medicines

CDL and PMB chronic medicine

100% Scheme tariff. Co-payment of 30% for non-formulary medicine.

Non-CDL chronic medicine

No benefit.

Biological medicine

PMBs only as per funding protocol. Subject to pre-authorisation

Other high-cost medicine

PMBs only as per funding protocol. Subject to pre-authorisation

acute medicine

Savings account.

Over-the-counter (OTC) medicine

Savings account.

Preventative care benefits

Flu vaccines
  • All ages
  • 1 per beneficiary per year
  • Applicable to all active members and beneficiaries
Pneumonia vaccines
  • Children <2 years
  • High-risk adult group

       Children:

  • As per schedule of Department of Health

       Adults:

  • Twice in a lifetime with booster above 65 years of age

       Adults:

  • The Scheme will identify certain high-risk individuals who will be advised to be immunised
Travel vaccines
  • All ages
  • Quantity and frequency depending on product up to to the maximum allowed amount
  • Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera from Scheme risk benefits
Paediatric immunisation
  • Babies and children
  • Funding for all paediatric vaccines according to the state-recommended programme
Baby growth and development assessments
  • 0-2 years
  • 3 assessments per year
  • Assessments are done at a Bestmed Network Pharmacy Clinic
Female contraceptives
  • All females of child-bearing age
  • Quantity and frequency depending on product up to the maximum allowed amount.
  • Mirena device - 1 device every 60 months
  • Limited to R2 550 per beneficiary per year. Includes all items classified in the category of female contraceptives
HPV vaccinations
  • Females 9-26 years of age
  • 3 vaccinations per beneficiary
  • Vaccinations will be funded at Mediscor Reference Price (MRP)
Back and neck preventative programme
  • All ages
  • Subject to pre-authorisation
  • Preferred providers (DBC/Workability Clinics)
  • This is a preventative programme with the objective of preventing back and neck surgery. The Scheme may identify appropriate participants
  • Based on the first assessment, a rehabilitation treatment plan is drawn up and initiated over an uninterrupted period that will be specified by the provider
  • Use of this programme is in lieu of surgery
    Mammogram (tariff code 34100)
    • Females 40 years and older
    • Once every 24 months
    • 100% Scheme tariff
    Preventative dentistry
    PSA screening
    • Males 50 years and older
    • Once every 24 months
    • Can be done at a urologist or Family Practitioner (FP)
    • Consultation paid from the available savings account
    Pap smear
    • Females 18 years and older
    • Once every 24 months
    • Can be done at a gynaecologist or Family Practitioner (FP)
    • Consultation paid from the available savings account

     

    Maternity benefits

    100% Scheme tariff. Subject to the following benefits

    Consultations: 
    • 6 antenatal consultations at a Family Practitioner OR gynaecologist OR midwife
    Ultrasounds:
    • 1 x 2D ultrasound scan at 1st trimester (between 10 to 12 weeks) at a Family Practitioner OR gynaecologist OR radiologist
    • 1 x 2D ultrasound scan at 2nd trimester (between 20 to 24 weeks) at a Family Practitioner OR gynaecologist OR radiologist

    From R 2323 per month*

    Add Dependants

    Adults
    0
    Children
    0

    Beat2 offers extensive hospital cover (at private hospitals) as well as access to a savings account for general day-to-day expenses.

    You pay for a maximum of three children. Any additional children can join as beneficiaries of the Scheme at no additional cost.

    Contributions
    Member: R2 323
    Adult dependant: R1 804
    Child dependant: R978
    Maximum child dependants: 3

    Bestmed members pay for only three child dependants. The rest is covered at no extra cost. Child dependants under the age of 24 years and registered students up to the age of 26 years, in accordance with the Rules, are regarded as child dependants.

    Get personalised pricing call for more information

    Beat2 Network

    Plan Details

    Hospital & Emergencies

    Accommodation (hospital stay) and theatre fees

    100% Scheme tariff.  DSP specialist network applicable if the network option is chosen.

    Take-home medicine

    100% Scheme tariff Limited to 7 days’ medicine

    Biological medicine during hospitalisation

    Limited to R15 855 per family per annum. Subject to pre-authorisation and funding guidelines.

    Treatment in mental health clinic

    100% scheme tariff Limited to 21 days per beneficiary

    Treatment of chemical and substance abuse

    100% Scheme tariff Limited to 21 days or R35 573 per beneficiary. Subject to network facilities.

    Consultations and procedures

    100% Scheme tariff.

    Surgical procedures and anaesthetics

    100% Scheme tariff. 

    Organ transplants

    100% Scheme tariff. (Only PMBs.)

    Major medical maxillo-facial surgery strictly related to certain conditions

    PMBs only at DSP day hospitals.

    Dental and oral surgery (In- or out of hospital)

    100% Scheme tariff. Subject to savings. 
    Beneficiaries 7 years and younger funded from Scheme risk. Limited to R5 782 per family.

    Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)

    100% Scheme tariff Limited to R86 841 per family.

    Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit *Functional: Item utilised towards treating or supporting a bodily function.

    Sub-limits per beneficiary:
      *Functional R31 000   Pacemaker (dual chamber) R47 344   Vascular R50 000   Endovascular and catheter-based procedures - no benefit   Spinal incl. artificial disk R34 661   Drug-eluting stents - PMBs and DSP products only   Mesh R12 164   Gynaecology/Urology R9 940   Lens implants R7 585 a lens per eye

    Prosthesis – External

    No benefit (PMBs only).

    Exclusions Limits and co-payments applicable. Preferred provider network available.

    Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
    Hip replacement and other major joints R36 489
    Knee replacement R44 990
    Other minor joints R13 995

    Orthopaedic and medical appliances

    100% Scheme tariff.

    Pathology

    100% Scheme tariff.

    Basic radiology

    100% Scheme tariff.

    Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans only included as indicated per option)

    100% Scheme tariff

    Oncology

    100% Scheme tariff Subject to pre-authorisation. DSP applies.

    Peritoneal dialysis and haemodialysis

    100% Scheme tariff Subject to pre-authorisation and DSPs

    Confinements (Birthing)

    100% Scheme tariff.

    Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)

    PMBs only.

    HIV/AIDS

    100% Scheme tariff. Subject to pre-authorisation and DSPs

    Midwife-assisted births

    100% Scheme tariff

    Supplementary services

    100% Scheme tariff.

    Alternatives to hospitalisation

    100% Scheme tariff

    Palliative care and Home-based care in lieu of hospitalisation

    100% Scheme tariff Limited to R63 420 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.

    Day procedures at a day-hospital facility

    Day procedures at DSPs and/or day hospitals will be funded at 100% network or Scheme tariffs. Voluntary use of non-DSP specialists and acute hospitals will result in a co-payment of R2 500.

    International travel cover

    Leisure Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 90 days, with R3 million for a family i.e. member and dependants.
    Business Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 45 days, with R3 million for a family i.e. member and dependants. 

    Co-payments

    Co-payment for voluntary use of non-network hospital R13 078 for Beat2 Network option.

    Day-to-Day

    FP and Specialist consultations

    Savings account.

    Basic and specialised dentistry

    Basic: Preventative benefit or savings account.
    Specialised: Savings account.
    Orthodontic: Subject to pre-authorisation.

    Medical aids, apparatus and appliances

    Savings account.

    Hearing aids

    Subject to pre-authorisation. Savings account.

    Supplementary services

    Savings account.

    Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)

    100% Scheme tariff. Limited to R 3 885 per family.

    Optometry benefit

    Savings account.

    Basic radiology and pathology

    Savings account.

    Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. Excluding PET scans)

    100% Scheme tariff. Limited to R5 885 per family.

    Oncology

    Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.

    HIV/AIDS

    100% Scheme tariff. Subject to pre-authorisation and DSPs.

    Peritoneal dialysis and haemodialysis

    100% Scheme tariff. Subject to pre-authorisation and DSPs.

    Rehabilitation services after trauma

    PMBs only. Subject to pre-authorisation and DSPs.

    Medicines

    CDL and PMB chronic medicine

    100% Scheme tariff. Co-payment of 30% for non-formulary medicine.

    Non-CDL chronic medicine

    No benefit.

    Biological medicine

    PMBs only as per funding protocol. Subject to pre-authorisation

    Other high-cost medicine

    PMBs only as per funding protocol. Subject to pre-authorisation

    acute medicine

    Savings account.

    Over-the-counter (OTC) medicine

    Savings account.

    Preventative care benefits

    Flu vaccines
    • All ages
    • 1 per beneficiary per year
    • Applicable to all active members and beneficiaries
    Pneumonia vaccines
    • Children <2 years
    • High-risk adult group

           Children:

    • As per schedule of Department of Health

           Adults:

    • Twice in a lifetime with booster above 65 years of age

           Adults:

    • The Scheme will identify certain high-risk individuals who will be advised to be immunised
    Travel vaccines
    • All ages
    • Quantity and frequency depending on product up to to the maximum allowed amount
    • Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera from Scheme risk benefits
    Paediatric immunisation
    • Babies and children
    • Funding for all paediatric vaccines according to the state-recommended programme
    Baby growth and development assessments
    • 0-2 years
    • 3 assessments per year
    • Assessments are done at a Bestmed Network Pharmacy Clinic
    Female contraceptives
    • All females of child-bearing age
    • Quantity and frequency depending on product up to the maximum allowed amount.
    • Mirena device - 1 device every 60 months
    • Limited to R2 550 per beneficiary per year. Includes all items classified in the category of female contraceptives
    HPV vaccinations
    • Females 9-26 years of age
    • 3 vaccinations per beneficiary
    • Vaccinations will be funded at Mediscor Reference Price (MRP)
    Back and neck preventative programme
    • All ages
    • Subject to pre-authorisation
    • Preferred providers (DBC/Workability Clinics)
    • This is a preventative programme with the objective of preventing back and neck surgery. The Scheme may identify appropriate participants
    • Based on the first assessment, a rehabilitation treatment plan is drawn up and initiated over an uninterrupted period that will be specified by the provider
    • Use of this programme is in lieu of surgery
      Mammogram (tariff code 34100)
      • Females 40 years and older
      • Once every 24 months
      • 100% Scheme tariff
      Preventative dentistry
      PSA screening
      • Males 50 years and older
      • Once every 24 months
      • Can be done at a urologist or Family Practitioner (FP)
      • Consultation paid from the available savings account
      Pap smear
      • Females 18 years and older
      • Once every 24 months
      • Can be done at a gynaecologist or Family Practitioner (FP)
      • Consultation paid from the available savings account

       

      Maternity benefits

      100% Scheme tariff. Subject to the following benefits

      Consultations: 
      • 6 antenatal consultations at a Family Practitioner OR gynaecologist OR midwife
      Ultrasounds:
      • 1 x 2D ultrasound scan at 1st trimester (between 10 to 12 weeks) at a Family Practitioner OR gynaecologist OR radiologist
      • 1 x 2D ultrasound scan at 2nd trimester (between 20 to 24 weeks) at a Family Practitioner OR gynaecologist OR radiologist

      From R 2090 per month*

      Add Dependants

      Adults
      0
      Children
      0

      Beat2 Network offers extensive hospital cover (at private hospitals) as well as access to a savings account for general day-to-day expenses.

      You pay for a maximum of three children. Any additional children can join as beneficiaries of the Scheme at no additional cost.

      Contributions
      Member: R2 090
      Adult dependant: R1 624
      Child dependant: R879
      Maximum child dependants: 3

      Bestmed members pay for only three child dependants. The rest is covered at no extra cost. Child dependants under the age of 24 years and registered students up to the age of 26 years, in accordance with the Rules, are regarded as child dependants.

      Get personalised pricing call for more information

      Beat3

      Plan Details

      Hospital & Emergencies

      Accommodation (hospital stay) and theatre fees

      100% Scheme tariff.  DSP specialist network applicable if the network option is chosen.

      Take-home medicine

      100% Scheme tariff Limited to 7 days’ medicine

      Biological medicine during hospitalisation

      Limited to R21 140 per family per annum. Subject to pre-authorisation and funding guidelines.

      Treatment in mental health clinic

      100% scheme tariff Limited to 21 days per beneficiary

      Treatment of chemical and substance abuse

      100% Scheme tariff Limited to 21 days or R35 573 per beneficiary. Subject to network facilities.

      Consultations and procedures

      100% Scheme tariff.

      Surgical procedures and anaesthetics

      100% Scheme tariff.

      Organ transplants

      100% Scheme tariff. (Only PMBs.)

      Major medical maxillo-facial surgery strictly related to certain conditions

      100% Scheme tariff. Limited to R14 256 per family

      Dental and oral surgery (In- or out of hospital)

      Limited to R8 893 per family.

      Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)

      100% Scheme tariff Limited too R87 757 per family.

      Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Item utilised towards treating or supporting a bodily function.

      Sub-limits per beneficiary:
        *Functional R32 000   Pacemaker (dual chamber) R47 344   Vascular R60 000   Endovascular and catheter-based procedures - no benefit   Spinal incl. artificial disk R34 789   Drug-eluting stents - PMBs and DSP products only   Mesh R12 227   Gynaecology/Urology R10 098   Lens implants R7 585 a lens per eye

      Prosthesis – External

      No benefit (PMBs only).

      Exclusions Limits and co-payments applicable. Preferred provider network available.

      Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
      • Hip replacement and other major joints R36 751   • Knee replacement R45 474   • Minor joints R13 995

      Orthopaedic and medical appliances

      100% Scheme tariff.

      Pathology

      100% Scheme tariff.

      Basic radiology

      100% Scheme tariff.

      Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans only included as indicated per option)

      100% Scheme tariff

      Oncology

      100% Scheme tariff Subject to pre-authorisation. DSP applies.

      Peritoneal dialysis and haemodialysis

      100% Scheme tariff Subject to pre-authorisation and DSPs

      Confinements (Birthing)

      100% Scheme tariff.

      Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)

      100% Scheme tariff
      Subject to pre-authorisation and protocols. Limited to R9 155 per eye.

      HIV/AIDS

      100% Scheme tariff. Subject to pre-authorisation and DSPs

      Midwife-assisted births

      100% Scheme tariff

      Supplementary services

      100% Scheme tariff.

      Alternatives to hospitalisation

      100% Scheme tariff

      Palliative care and Home-based care in lieu of hospitalisation

      100% Scheme tariff limited to R63 420 per annum. Subject to available benefit, pre-authorisation and treatment plan.

      Day procedures at a day-hospital facility

      Day procedures at DSPs and/or day-hospitals will be funded at 100%  network or Scheme tariffs. Voluntary use of non-DSP specialists and acute hospitals will result in a co-payment of R2 500.

      International travel cover

      Leisure Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 90 days, with R3 million for a family i.e. member and dependants.
      Business Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 45 days, with R3 million for a family i.e. member and dependants. 

      Co-payments

      Co-payment for voluntary use of non-network hospital R13 078 for network option.

      Day-to-Day

      FP and Specialist consultations

      Savings account.

      Basic and specialised dentistry

      Basic: Preventative benefit or savings account.
      Specialised: Savings account.
      Orthodontic: Subject to pre-authorisation.

      Medical aids, apparatus and appliances

      Savings account.

      Hearing aids

      Subject to pre-authorisation. Savings account.

      Supplementary services

      Savings account.

      Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)

      100% Scheme tariff. Limited to R 3 885 per family.

      Optometry benefit

      Savings account.

      Basic radiology and pathology

      Savings account.

      Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. Excluding PET scans)

      100% Scheme tariff. Limited to R12 361 per family.

      Oncology

      Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.

      HIV/AIDS

      100% Scheme tariff. Subject to pre-authorisation and DSPs.

      Peritoneal dialysis and haemodialysis

      100% Scheme tariff. Subject to pre-authorisation and DSPs.

      Rehabilitation services after trauma

      PMBs only. Subject to pre-authorisation and DSPs.

      Medicines

      CDL and PMB chronic medicine

      100% Scheme tariff. Co-payment of 30% for non-formulary medicine.

      Non-CDL chronic medicine

      5 conditions. 80% Scheme tariff. Limited to M = R3 793, M1+ = R7 716. Co-payment of 30% for non-formulary medicine.

      Biological medicine

      PMBs only as per funding protocol. Subject to pre-authorisation

      Other high-cost medicine

      PMBs only as per funding protocol. Subject to pre-authorisation

      Acute medicine

      Savings account.

      Over-the-counter (OTC) medicine

      Savings account.

      Preventative care benefits

      Flu vaccines
      • All ages
      • 1 per beneficiary per year
      • Applicable to all active members and beneficiaries
      Pneumonia vaccines
      • Children <2 years
      • High-risk adult group

             Children:

      • As per schedule of Department of Health

             Adults:

      • Twice in a lifetime with booster above 65 years of age

             Adults:

      • The Scheme will identify certain high-risk individuals who will be advised to be immunised
      Travel vaccines
      • All ages
      • Quantity and frequency depending on product up to to the maximum allowed amount
      • Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera from Scheme risk benefits
      Paediatric immunisation
      • Babies and children
      • Funding for all paediatric vaccines according to the state-recommended programme
      Baby growth and development assessments
      • 0-2 years
      • 3 assessments per year
      • Assessments are done at a Bestmed Network Pharmacy Clinic
      Female contraceptives
      • All females of child-bearing age
      • Quantity and frequency depending on product up to the maximum allowed amount.
      • Mirena device - 1 device every 60 months
      • Limited to R2 550 per beneficiary per year. Includes all items classified in the category of female contraceptives
      HPV vaccinations
      • Females 9-26 years of age
      • 3 vaccinations per beneficiary
      • Vaccinations will be funded at Mediscor Reference Price (MRP)
      Back and neck preventative programme
      • All ages
      • Subject to pre-authorisation
      • Preferred providers (DBC/Workability Clinics)
      • This is a preventative programme with the objective of preventing back and neck surgery. The Scheme may identify appropriate participants
      • Based on the first assessment, a rehabilitation treatment plan is drawn up and initiated over an uninterrupted period that will be specified by the provider
      • Use of this programme is in lieu of surgery
        Mammogram (tariff code 34100)
        • Females 40 years and older
        • Once every 24 months
        • 100% Scheme tariff
        Preventative dentistry
        PSA screening
        • Males 50 years and older
        • Once every 24 months
        • Can be done at a urologist or Family Practitioner (FP)
        • Consultation paid from the available savings account
        Pap smear
        • Females 18 years and older
        • Once every 24 months
        • Can be done at a gynaecologist or Family Practitioner (FP)
        • Consultation paid from the available savings account

         

        Maternity benefits

        100% Scheme tariff. Subject to the following benefits:

        Consultations: 
        • 9 antenatal consultations at a Family Practitioner OR gynaecologist OR midwife
        • 1 post-natal consultation at a Family Practitioner OR gynaecologist OR midwife
        Ultrasounds:
        • 1 x 2D ultrasound scan at 1st trimester (between 10 to 12 weeks) at a Family Practitioner OR gynaecologist OR radiologist
        • 1 x 2D ultrasound scan at 2nd trimester (between 20 to 24 weeks) at a Family Practitioner OR gynaecologist OR radiologist
        Supplements:
        • Any item categorised as a maternity supplement can be claimed up to a maximum of R127 per claim, once a month, for a maximum of 9 months

        From R 3400 per month*

        Add Dependants

        Adults
        0
        Children
        0

        Beat3 offers extensive in-hospital cover with savings and additional benefits, including comprehensive maternity benefits.

        You pay for a maximum of three children. Any additional children can join as beneficiaries of the Scheme at no additional cost.

        Contributions
        Member: R3 400
        Adult dependant: R2 425
        Child dependant: R1 200
        Maximum child dependants: 3

        Bestmed members pay for only three child dependants. The rest is covered at no extra cost. Child dependants under the age of 24 years and registered students up to the age of 26 years, in accordance with the Rules, are regarded as child dependants.

        Get personalised pricing call for more information

        Beat3 Network

        Plan Details

        Hospital & Emergencies

        Accommodation (hospital stay) and theatre fees

        100% Scheme tariff.  DSP specialist network applicable if the network option is chosen.

        Take-home medicine

        100% Scheme tariff Limited to 7 days’ medicine

        Biological medicine during hospitalisation

        Limited to R21 140 per family per annum. Subject to pre-authorisation and funding guidelines.

        Treatment in mental health clinic

        100% scheme tariff Limited to 21 days per beneficiary

        Treatment of chemical and substance abuse

        100% Scheme tariff Limited to 21 days or R35 573 per beneficiary. Subject to network facilities.

        Consultations and procedures

        100% Scheme tariff.

        Surgical procedures and anaesthetics

        100% Scheme tariff.

        Organ transplants

        100% Scheme tariff. (Only PMBs.)

        Major medical maxillo-facial surgery strictly related to certain conditions

        100% Scheme tariff. Limited to R14 256 per family

        Dental and oral surgery (In- or out of hospital)

        Limited to R8 893 per family.

        Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)

        100% Scheme tariff Limited too R87 757 per family.

        Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Item utilised towards treating or supporting a bodily function.

        Sub-limits per beneficiary:
          *Functional R32 000   Pacemaker (dual chamber) R47 344   Vascular R60 000   Endovascular and catheter-based procedures - no benefit   Spinal incl. artificial disk R34 789   Drug-eluting stents - PMBs and DSP products only   Mesh R12 227   Gynaecology/Urology R10 098   Lens implants R7 585 a lens per eye

        Prosthesis – External

        No benefit (PMBs only).

        Exclusions Limits and co-payments applicable. Preferred provider network available.

        Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
        • Hip replacement and other major joints R36 751   • Knee replacement R45 474   • Minor joints R13 995

        Orthopaedic and medical appliances

        100% Scheme tariff.

        Pathology

        100% Scheme tariff.

        Basic radiology

        100% Scheme tariff.

        Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans only included as indicated per option)

        100% Scheme tariff

        Oncology

        100% Scheme tariff Subject to pre-authorisation. DSP applies.

        Peritoneal dialysis and haemodialysis

        100% Scheme tariff Subject to pre-authorisation and DSPs

        Confinements (Birthing)

        100% Scheme tariff.

        Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)

        100% Scheme tariff
        Subject to pre-authorisation and protocols. Limited to R9 155 per eye.

        HIV/AIDS

        100% Scheme tariff. Subject to pre-authorisation and DSPs

        Midwife-assisted births

        100% Scheme tariff

        Supplementary services

        100% Scheme tariff.

        Alternatives to hospitalisation

        100% Scheme tariff

        Palliative care and Home-based care in lieu of hospitalisation

        100% Scheme tariff limited to R63 420 per annum. Subject to available benefit, pre-authorisation and treatment plan.

        Day procedures at a day-hospital facility

        Day procedures at DSPs and/or day-hospitals will be funded at 100%  network or Scheme tariffs. Voluntary use of non-DSP specialists and acute hospitals will result in a co-payment of R2 500.

        Emergency evacuation

        Services rendered by ER24.

        International travel cover

        Leisure Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 90 days, with R3 million for a family i.e. member and dependants.
        Business Travel: Limited to 45 days and R500 000 cover for travel to the USA. All other countries covered up to 45 days, with R3 million for a family i.e. member and dependants. 

        Co-payments

        Co-payment for voluntary use of non-network hospital R13 078 for network option.

        Day-to-Day

        FP and Specialist consultations

        Savings account.

        Basic and specialised dentistry

        Basic: Preventative benefit or savings account.
        Specialised: Savings account.
        Orthodontic: Subject to pre-authorisation.

        Medical aids, apparatus and appliances

        Savings account.

        Hearing aids

        Subject to pre-authorisation. Savings account.

        Supplementary services

        Savings account.

        Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)

        100% Scheme tariff. Limited to R 3 885 per family.

        Optometry benefit

        Savings account.

        Basic radiology and pathology

        Savings account.

        Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. Excluding PET scans)

        100% Scheme tariff. Limited to R12 361 per family.

        Oncology

        Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.

        HIV/AIDS

        100% Scheme tariff. Subject to pre-authorisation and DSPs.

        Peritoneal dialysis and haemodialysis

        100% Scheme tariff. Subject to pre-authorisation and DSPs.

        Rehabilitation services after trauma

        PMBs only. Subject to pre-authorisation and DSPs.

        Medicines

        CDL and PMB chronic medicine

        100% Scheme tariff. Co-payment of 30% for non-formulary medicine.

        Non-CDL chronic medicine

        5 conditions. 80% Scheme tariff. Limited to M = R3 793, M1+ = R7 716. Co-payment of 30% for non-formulary medicine.

        Biological medicine

        PMBs only as per funding protocol. Subject to pre-authorisation

        Other high-cost medicine

        PMBs only as per funding protocol. Subject to pre-authorisation

        Acute medicine

        Savings account.

        Over-the-counter (OTC) medicine

        Savings account.

        Preventative care benefits

        Flu vaccines
        • All ages
        • 1 per beneficiary per year
        • Applicable to all active members and beneficiaries
        Pneumonia vaccines
        • Children <2 years
        • High-risk adult group

               Children:

        • As per schedule of Department of Health

               Adults:

        • Twice in a lifetime with booster above 65 years of age

               Adults:

        • The Scheme will identify certain high-risk individuals who will be advised to be immunised
        Travel vaccines
        • All ages
        • Quantity and frequency depending on product up to to the maximum allowed amount
        • Mandatory travel vaccines for typhoid, yellow fever, tetanus, meningitis, hepatitis and cholera from Scheme risk benefits
        Paediatric immunisation
        • Babies and children
        • Funding for all paediatric vaccines according to the state-recommended programme
        Baby growth and development assessments
        • 0-2 years
        • 3 assessments per year
        • Assessments are done at a Bestmed Network Pharmacy Clinic
        Female contraceptives
        • All females of child-bearing age
        • Quantity and frequency depending on product up to the maximum allowed amount.
        • Mirena device - 1 device every 60 months
        • Limited to R2 550 per beneficiary per year. Includes all items classified in the category of female contraceptives
        HPV vaccinations
        • Females 9-26 years of age
        • 3 vaccinations per beneficiary
        • Vaccinations will be funded at Mediscor Reference Price (MRP)
        Back and neck preventative programme
        • All ages
        • Subject to pre-authorisation
        • Preferred providers (DBC/Workability Clinics)
        • This is a preventative programme with the objective of preventing back and neck surgery. The Scheme may identify appropriate participants
        • Based on the first assessment, a rehabilitation treatment plan is drawn up and initiated over an uninterrupted period that will be specified by the provider
        • Use of this programme is in lieu of surgery
          Mammogram (tariff code 34100)
          • Females 40 years and older
          • Once every 24 months
          • 100% Scheme tariff
          Preventative dentistry
          PSA screening
          • Males 50 years and older
          • Once every 24 months
          • Can be done at a urologist or Family Practitioner (FP)
          • Consultation paid from the available savings account
          Pap smear
          • Females 18 years and older
          • Once every 24 months
          • Can be done at a gynaecologist or Family Practitioner (FP)
          • Consultation paid from the available savings account

           

          Maternity benefits

          100% Scheme tariff. Subject to the following benefits:

          Consultations: 
          • 9 antenatal consultations at a Family Practitioner OR gynaecologist OR midwife
          • 1 post-natal consultation at a Family Practitioner OR gynaecologist OR midwife
          Ultrasounds:
          • 1 x 2D ultrasound scan at 1st trimester (between 10 to 12 weeks) at a Family Practitioner OR gynaecologist OR radiologist
          • 1 x 2D ultrasound scan at 2nd trimester (between 20 to 24 weeks) at a Family Practitioner OR gynaecologist OR radiologist
          Supplements:
          • Any item categorised as a maternity supplement can be claimed up to a maximum of R127 per claim, once a month, for a maximum of 9 months

          From R 3060 per month*

          Add Dependants

          Adults
          0
          Children
          0

          Beat3 Network offers extensive in-hospital cover with savings and additional benefits, including comprehensive maternity benefits. This plan is associated with network hospitals and providers.

          You pay for a maximum of three children. Any additional children can join as beneficiaries of the Scheme at no additional cost.

          Contributions
          Member: R3 060
          Adult dependant: R2 183
          Child dependant: R1 080
          Maximum child dependants: 3

          Bestmed members pay for only three child dependants. The rest is covered at no extra cost. Child dependants under the age of 24 years and registered students up to the age of 26 years, in accordance with the Rules, are regarded as child dependants.

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