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24h Emergency: 084 124

Beat2 Network

Plan Details

Hospital & Emergencies

Accommodation (hospital stay) and theatre fees

100% Scheme tariff.  DSP specialist network applicable.

Take-home medicine

100% Scheme tariff Limited to 7 days’ medicine

Biological medicine during hospitalisation

Limited to R15 000 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 R33 655 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.

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

100% Scheme tariff Limited to R82 158 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 limited to R14 698  • Pacemaker (dual chamber) R44 791   • Vascular R312 792   • Endovascular and catheter base procedures - no benefit   • Spinal R32 792   • Artificial disc - no benefit   • Drug-eluting stents - PMBs and DSP products only   • Mesh R11 508  • Gynaecology/Urology R9 404  • Lens implants R7 176 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 R34 522   • Knee replacement R42 564   • Other minor joints R13 240

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)

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 R60 000 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.

Day procedures at a day-hospital facility

Day procedures at a day-hospital facility funded at 100% Scheme tariff. Subject to pre-authorisation. DSPs apply for PMBs

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 R5 million for one member and R10 million for principal 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 R5 million for one member and R10 million for principal member and dependants.

Co-payments

Co-payment for voluntary use of non-network hospital R12 373 for Beat2 Network option.

Day-to-Day

FP and Specialist consultations

Savings account.

Diabetes primary care consultation

100% of Scheme tariff subject to registration with Halocare. 2 primary care consultations at Dis-Chem Pharmacies.

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 3 675 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 567 per family.

Oncology

Oncology programme at 100% of Scheme tariff.

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.

Biologicals and 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 412 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
  • 1 lactation consultation with a registered nurse or lactation specialist.
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 1919 per month*

Add Dependants

Adults
0
Children
0

Beat2 Network offers extensive hospital cover (at network 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: R1 919
Adult dependant: R1 491
Child dependant: R807
Maximum child dependants: 3

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

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

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 R33 655 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.

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

100% Scheme tariff Limited to R82 158 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 limited to R14 698  • Pacemaker (dual chamber) R44 791   • Vascular R312 792   • Endovascular and catheter base procedures - no benefit   • Spinal R32 792   • Artificial disc - no benefit   • Drug-eluting stents - PMBs and DSP products only   • Mesh R11 508  • Gynaecology/Urology R9 404  • Lens implants R7 176 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 R34 522   • Knee replacement R42 564   • Other minor joints R13 240

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 R60 000 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.

Day procedures at a day-hospital facility

Day procedures at a day-hospital facility funded at 100% Scheme tariff. Subject to pre-authorisation. DSPs apply for PMBs

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 R5 million for one member and R10 million for principal 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 R5 million for one member and R10 million for principal member and dependants.

Co-payments

Co-payment for voluntary use of non-network hospital R12 373 for Beat2 Network option.

Day-to-Day

FP and Specialist consultations

Savings account.

Diabetes primary care consultation

100% of Scheme tariff subject to registration with Halocare. 2 primary care consultations at Dis-Chem Pharmacies.

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 3 675 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 567 per family.

Oncology

Oncology programme at 100% of Scheme tariff.

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.

Biologicals and 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 412 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
    • 1 lactation consultation with a registered nurse or lactation specialist.
    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 2133 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 133
    Adult dependant: R1 656
    Child dependant: R898
    Maximum child dependants: 3

    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

    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 R32 299 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 R12 944 per family

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

    Limited to R8 075 per family.

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

    100% Scheme tariff Limited too R79 678 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 limited to R14 107 • Pacemaker (dual chamber) R42 986 • Vascular R31 586 • Endovascular and catheter base procedures - no benefit • Spinal R31 586   • Artificial disc - no benefit • Drug-eluting stents - PMBs and DSP products only • Mesh R11 101 • Gynaecology/Urology R9 168  • Lens implants R6 887 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 R33 368   • Knee replacement R41 288   • Minor joints R12 706

    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.

    Mammary surgery (Breast cancer patient)

    No benefit
    for reconstructive surgery (which may include symmetrising, partial or total mastectomy etc.) on the unaffected (non-cancerous) breast of a breast cancer patient.

    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 R8 312 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 R24 000 per annum. Subject to available benefit, pre-authorisation and treatment plan.

    Day procedures at a day-hospital facility

    Day procedures at a day-hospital facility funded at 100% Scheme tariff. Subject to pre-authorisation. DSPs apply for PMBs

    Emergency evacuation

    Services rendered by ER24.

    International travel cover

    Up to R10 million and a maximum of 90 days.  Services rendered by Bryte Insurance and managed by ER24.

    Co-payments

    Co-payment of R3 800 on all endoscopic investigations and specialised diagnostic imaging
    if done in a private hospital. Any other facility,
    no co-payment. Co-payment for voluntary use of non-network hospital R11 874 for network option.

    Day-to-Day

    FP and Specialist consultations

    Savings account.

    Diabetes primary care consultation

    100% of Scheme tariff subject to registration with Halocare. 2 primary care consultations at Dis-Chem Pharmacies.

    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 3 675 per family.

    Optometry benefit

    Benefits available every 24 months from date of service.

    Network Provider (PPN)
    Consultation - 1 per beneficiary.
    Frame = R860 covered AND
    100% of cost of standard lenses (single vision OR bifocal OR multifocal) OR
    Contact lenses = R1 630

    Non-network Provider
    Consultation - R350 fee at non-network provider
    Frame = R598 AND
    Single vision lenses = R210 OR
    Bifocal lenses = R445 OR
    Multifocal lenses = R1 000
    In lieu of glasses members can opt for contact lenses, limited to R1 630

    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 R11 694 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 589, M1+ = R7 300. Co-payment of 30% for non-formulary medicine.

    Biologicals and other high-cost medicine

    PMBs only as per funding protocol.

    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 412 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
      • 1 lactation consultation with a registered nurse or lactation specialist.
      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 R120 per claim, once a month, for a maximum of 9 months

      From R 2914 per month*

      Add Dependants

      Adults
      0
      Children
      0

      Beat3 Network offers extensive in-hospital cover with savings and additional benefits, including 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: R2 914
      Adult dependant: R2 073
      Child dependant: R1 127
      Maximum child dependants: 3

      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

      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 R32 299 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 R12 944 per family

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

      Limited to R8 075 per family.

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

      100% Scheme tariff Limited too R79 678 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 limited to R14 107 • Pacemaker (dual chamber) R42 986 • Vascular R31 586 • Endovascular and catheter base procedures - no benefit • Spinal R31 586   • Artificial disc - no benefit • Drug-eluting stents - PMBs and DSP products only • Mesh R11 101 • Gynaecology/Urology R9 168  • Lens implants R6 887 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 R33 368   • Knee replacement R41 288   • Minor joints R12 706

      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.

      Mammary surgery (Breast cancer patient)

      No benefit
      for reconstructive surgery (which may include symmetrising, partial or total mastectomy etc.) on the unaffected (non-cancerous) breast of a breast cancer patient.

      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 R8 312 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 R24 000 per annum. Subject to available benefit, pre-authorisation and treatment plan.

      Day procedures at a day-hospital facility

      Day procedures at a day-hospital facility funded at 100% Scheme tariff. Subject to pre-authorisation. DSPs apply for PMBs

      Emergency evacuation

      Services rendered by ER24.

      International travel cover

      Up to R10 million and a maximum of 90 days.  Services rendered by Bryte Insurance and managed by ER24.

      Co-payments

      Co-payment of R3 800 on all endoscopic investigations and specialised diagnostic imaging
      if done in a private hospital. Any other facility,
      no co-payment. Co-payment for voluntary use of non-network hospital R11 874 for network option.

      Day-to-Day

      FP and Specialist consultations

      Savings account.

      Diabetes primary care consultation

      100% of Scheme tariff subject to registration with Halocare. 2 primary care consultations at Dis-Chem Pharmacies.

      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 3 675 per family.

      Optometry benefit

      Benefits available every 24 months from date of service.

      Network Provider (PPN)
      Consultation - 1 per beneficiary.
      Frame = R860 covered AND
      100% of cost of standard lenses (single vision OR bifocal OR multifocal) OR
      Contact lenses = R1 630

      Non-network Provider
      Consultation - R350 fee at non-network provider
      Frame = R598 AND
      Single vision lenses = R210 OR
      Bifocal lenses = R445 OR
      Multifocal lenses = R1 000
      In lieu of glasses members can opt for contact lenses, limited to R1 630

      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 R11 694 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 589, M1+ = R7 300. Co-payment of 30% for non-formulary medicine.

      Biologicals and other high-cost medicine

      PMBs only as per funding protocol.

      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 412 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
        • 1 lactation consultation with a registered nurse or lactation specialist.
        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 R120 per claim, once a month, for a maximum of 9 months

        From R 3239 per month*

        Add Dependants

        Adults
        0
        Children
        0

        Beat 3 offers extensive in-hospital cover with savings and additional benefits, including 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 239
        Adult dependant: R2 301
        Child dependant: R1 250
        Maximum child dependants: 3

        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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