Browse options that offer savings account access for general day-to-day benefits, as well as extensive hospital cover at private hospitals
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff if claimed on the day of discharge. Limited to: A maximum of 7 days treatment if claimed as part of the hospital account, or R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge
Biological medicine during hospitalisation
Limited to R17 414 per family per annum. Subject to pre-authorisation and funding guidelines.
Treatment in mental health clinic
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation.
Treatment of chemical and substance abuse
Benefits shall be limited to the treatment of PMB conditions and subject to the following: Pre-authorisation,DSPs, and 21 days’ stay for in-hospital management per beneficiary per annum.
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (PMBs only)
Stem cell transplants
100% Scheme tariff. (PMBs only)
Major medical maxillo-facial surgery strictly related to certain conditions
PMBs only.
Dental and oral surgery (In- or out of hospital)
PMBs only at DSP day hospitals. Beneficiaries 7 years and younger Limited to R6 350 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 R95 377 per family per annum
Prosthesis – Internal Note: Sub-limits subject to availability of overall prosthesis limit. DSPs apply. *Functional: Items used to replace or augment an impaired bodily function
Sub-limits per beneficiary per annum: Functional R34 047. Pacemaker (single and dual chamber) R51 998. Vascular R54 915. Spinal including artificial disc R38 068. Drug-eluting stents - subject to Vascular prosthesis limit. Mesh R13 360. Gynaecology/urology R10 917. Lens implants R8 330 a lens per eye.
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
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 R40 075. Knee replacement R49 413. Other minor joints R15 371.
Orthopaedic and medical appliances *Note: Appliances directly relating to the hospital admission and/or procedure
100% Scheme tariff. Limited to R15 000 per family per annum.
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. Limited to a combined in- and out-of hospital benefit of R22 000 per family per annum. Co-payment of R2 100 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Oncology
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP.
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
Advanced illness benefit
100% Scheme tariff, limited to R69 654 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Day procedures
Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time
International travel cover
Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA. Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA.
Co-payments
Non-network hospital co-payment Co-payment for voluntary use of non-network hospital R14 364 applicable to network options. Procedure-specific co-payments: The co-payment shall not apply to PMB conditions:Arthroscopic procedures R3 660. Back and neck surgery R3 660. Functional nasal and sinus procedures R2 000. Laparoscopic procedures R3 660. Colonoscopies R2 000. Cystoscopies R2 000.Gastroscopies R2 000. Hysteroscopies R2 000. Sigmoidoscopies R2 000. A co-payment of R2 746, as described in the Day procedures benefit, will be incurred per event if a day procedure is done in an acute hospital that is not a day hospital.
GP 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 R4 267 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 a combined in- and out-ofhospital benefit of R22 000 per family per annum. Co-payment of R2 100 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
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.
Managed Healthcare - Back and Neck Preventative Programme
Benefits payable at 100% of contracted fee.
Rehabilitation services after trauma
PMBs only. Subject to pre-authorisation and DSPs.
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.
Other high-cost medicine
PMBs only as per funding protocol.
acute medicine
Savings account.
Over-the-counter (OTC) medicine
Savings account.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits
Add Dependants
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 869
Adult dependant: R2 228
Child dependant: R1 208
Maximum child dependants: 3
Bestmed members pay for only three child dependants. Any additional children can join as beneficiaries of the Scheme at no additional cost. Dependants under the age of 24 years are regarded as child dependants.
Get personalised pricing
call for more information 
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff if claimed on the day of discharge. Limited to: A maximum of 7 days treatment if claimed as part of the hospital account, or R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge
Biological medicine during hospitalisation
Limited to R17 414 per family per annum. Subject to pre-authorisation and funding guidelines.
Treatment in mental health clinic
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation.
Treatment of chemical and substance abuse
Benefits shall be limited to the treatment of PMB conditions and subject to the following: Pre-authorisation, DSPs, 21 days’ stay for in-hospital management per beneficiary per annum
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (PMBs only).
Stem cell transplants
100% Scheme tariff. (PMBs only).
Major medical maxillo-facial surgery strictly related to certain conditions
PMBs only.
Dental and oral surgery (In- or out of hospital)
PMBs only at DSP day hospitals. Beneficiaries 7 years and younger Limited to R6 350 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 R95 377 per family per annum.
Prosthesis – Internal Note: Note: Sub-limits subject to availability of overall prosthesis limit. DSPs apply. *Functional: Items used to replace or augment an impaired bodily function.
Sub-limits per beneficiary per annum: *Functional R34 047. Pacemaker (single and dual chamber) R51 998. Vascular R54 915. Spinal including artificial disc R38 068. Drug-eluting stents - subject to Vascular prosthesis limit. Mesh R13 360. Gynaecology/urology R10 917. Lens implants R8 330 a lens per eye.
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
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 R40 075. Knee replacement R49 413. Other minor joints R15 371
Orthopaedic and medical appliances
100% Scheme tariff. Limited to R15 000 per family per annum.
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. Limited to a combined in- and out-of hospital benefit of R22 000 per family per annum. Co-payment of R2 100 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Oncology
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP
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
Advanced illness benefit
100% Scheme tariff, limited to R69 654 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Day procedures
Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time.
International travel cover
Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA. Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA
Co-payments
Non-network hospital co-payment Co-payment for voluntary use of non-network hospital R14 364 applicable to network options. Procedure-specific co-payments: The co-payment shall not apply to PMB conditions: Arthroscopic procedures R3 660. Back and neck surgery R3 660. Functional nasal and sinus procedures R2 000. Laparoscopic procedures R3 660. Colonoscopies R2 000. Cystoscopies R2 000. Gastroscopies R2 000. Hysteroscopies R2 000. Sigmoidoscopies R2 000. A co-payment of R2 746, as described in the Day procedures benefit, will be incurred per event if a day procedure is done in an acute hospital that is not a day hospital.
GP 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 R4 267 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 a combined in- and out-ofhospital benefit of R22 000 per family per annum. Co-payment of R2 100 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Oncology
Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation, protocols 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.
Managed Healthcare - Back and Neck Preventative Programme
Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs
Rehabilitation services after trauma
PMBs only. Subject to pre-authorisation and DSPs.
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.
Other high-cost medicine
PMBs only as per funding protocol.
acute medicine
Savings account.
Over-the-counter (OTC) medicine
Savings account.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits
Add Dependants
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 581
Adult dependant: R2 006
Child dependant: R1 086
Maximum child dependants: 3
Bestmed members pay for only three child dependants. Any additional children can join as beneficiaries of the Scheme at no additional cost. Dependants under the age of 24 years are regarded as child dependants.
Get personalised pricing
call for more information
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff if claimed on the day of discharge. Limited to: A maximum of 7 days treatment if claimed as part of the hospital account, or R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge.
Biological medicine during hospitalisation
Limited to R23 218 per family per annum. Subject to pre-authorisation and funding guidelines.
Treatment in mental health clinic
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation.
Treatment of chemical and substance abuse
Benefits shall be limited to the treatment of PMB conditions and subject to the following: Pre-authorisation, DSPs, and 21 days’ stay for in-hospital management per beneficiary per annum.
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (PMBs only
Stem cell transplants
100% Scheme tariff. (PMBs only)
Major medical maxillo-facial surgery strictly related to certain conditions
100% Scheme tariff. Limited to R15 658 per family per annum Limited to R14 969 per family
Dental and oral surgery (In- or out of hospital)
Limited to R9 768 per family per annum.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R96 384 per family per annum.
Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Items used to replace or augment an impaired bodily function.
Sub-limits per beneficiary per annum: *Functional R35 146. Pacemaker (single and dual chamber) R51 998. Vascular R65 898. Spinal including artificial disc R38 208. Drug-eluting stents - subject to Vascular prosthesis limit. Mesh R13 429. Gynaecology/urology R11 091. Lens implants R8 330 a lens per eye.
Prosthesis – External
No benefit (PMBs only).
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
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 R40 364. Knee replacement R49 944. Other minor joints R15 371.
Orthopaedic and medical appliances
100% Scheme tariff. Limited to R15 000 per family per annum.
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)
Limited to a combined in- and out-of hospital benefit of R32 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Oncology
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP
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 R10 055 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
Advanced illness benefit
100% Scheme tariff, limited to R69 654 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Day procedures
Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time.
International travel cover
Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA. Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA.
Co-payments
Non-network hospital co-payment Co-payment for voluntary use of non-network hospital R14 364 applicable to network options. Procedure-specific co-payments:The co-payment shall not apply to PMB conditions: Arthroscopic procedures R3 660. Back and neck surgery R3 660. Functional nasal and sinus procedures R2 000. Laparoscopic procedures R3 660. Colonoscopies R2 000. Cystoscopies R2 000. Gastroscopies R2 000. Hysteroscopies R2 000. Sigmoidoscopies R2 000. Extraction of wisdom teeth R2 500. A co-payment of R2 746, as described in the Day procedures benefit, will be incurred per event if a day procedure is done in an acute hospital that is not a day hospital.
GP 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 R4 267 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 a combined in- and out-ofhospital benefit of R32 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation
Oncology
Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation, protocols 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.
Managed Healthcare - Back and Neck Preventative Programme
Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs.
Rehabilitation services after trauma
PMBs only. Subject to pre-authorisation and DSPs.
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 = R4 166, M1+ = R8 475. Co-payment of 30% for non-formulary medicine.
Biological medicine
PMBs only as per funding protocol.
Other high-cost medicine
PMBs only as per funding protocol.
Acute medicine
Savings account.
Over-the-counter (OTC) medicine
Savings account.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits:
Add Dependants
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: R4 199
Adult dependant: R2 995
Child dependant: R 1 482
Maximum child dependants: 3
Bestmed members pay for only three child dependants. Any additional children can join as beneficiaries of the Scheme at no additional cost. Dependants under the age of 24 years are regarded as child dependants.
Get personalised pricing
call for more information
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff if claimed on the day of discharge. Limited to: A maximum of 7 days treatment if claimed as part of the hospital account, or R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge.
Biological medicine during hospitalisation
Limited to R23 218 per family per annum. Subject to pre-authorisation and funding guidelines.
Treatment in mental health clinic
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation
Treatment of chemical and substance abuse
Benefits shall be limited to the treatment of PMB conditions and subject to the following: Pre-authorisation , DSPs, 21 days’ stay for in-hospital management per beneficiary per annum.
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (Only PMBs.)
Stem cell transplants
100% Scheme tariff. (Only PMBs.)
Major medical maxillo-facial surgery strictly related to certain conditions
100% Scheme tariff. Limited to R15 658 per family per annum.
Dental and oral surgery (In- or out of hospital)
Limited to R9 768 per family per annum.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R96 384 per family per annum.
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 per annum: • *Functional R35 146. • Pacemaker (single and dual chamber) R51 998. • Vascular R65 898. • Spinal including artificial disc R38 208. • Drug-eluting stents - subject to Vascular prosthesis limit. • Mesh R13 429. • Gynaecology/urology R11 091. • Lens implants R8 330 a lens per eye.
Prosthesis – External
No benefit (PMBs only).
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
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 R40 364. • Knee replacement R49 944. • Other minor joints R15 371.
Orthopaedic and medical appliances
100% Scheme tariff. Limited to R15 000 per family per annum.
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)
Limited to a combined in- and out ofhospital benefit of R32 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation
Oncology
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP
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 R10 055 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
Advanced illness benefit
100% Scheme tariff, limited to R69 654 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Day procedures
Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time.
International travel cover
• Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA. • Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA.
Co-payments
Non-network hospital co-payment Co-payment for voluntary use of non-network hospital R14 364 applicable to network options. Procedure-specific co-payments: The co-payment shall not apply to PMB conditions: Arthroscopic procedures R3 660. Back and neck surgery R3 660. Functional nasal and sinus procedures R2 000. Laparoscopic procedures R3 660. Colonoscopies R2 000. Cystoscopies R2 000. Gastroscopies R2 000. Hysteroscopies R2 000. Sigmoidoscopies R2 000. Extraction of wisdom teeth R2 500. A co-payment of R2 746, as described in the Day procedures benefit, will be incurred per event if a day procedure is done in an acute hospital that is not a day hospital
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 R4 267 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 a combined in- and out-of hospital benefit of R32 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
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.
Managed Healthcare - Back and Neck Preventative Programme
Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs. Subject to pre-authorisation, protocols and DSPs.
Rehabilitation services after trauma
PMBs only. Subject to pre-authorisation and DSPs.
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 = R4 166, M1+ = R8 475. 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.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits:
Add Dependants
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 779
Adult dependant: R2 696
Child dependant: R1 334
Maximum child dependants: 3
Bestmed members pay for only three child dependants. Any additional children can join as beneficiaries of the Scheme at no additional cost. Dependants under the age of 24 years are regarded as child dependants.
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Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff if claimed on the day of discharge. Limited to: A maximum of 7 days treatment if claimed as part of the hospital account, or R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge.
Biological medicine during hospitalisation
Limited to R23 218 per family per annum. Subject to pre-authorisation and funding guidelines.
Treatment in mental health facilities
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation.
Treatment of chemical and substance abuse
Benefits shall be limited to the treatment of PMB conditions and subject to the following: Pre-authorisation, DSPs, and 21 days’ stay for in-hospital management per beneficiary per annum.
Consultations and procedures
100% Scheme tariff.
Surgical procedures and anaesthetics
100% Scheme tariff.
Organ transplants
100% Scheme tariff. (PMBs Only).
Stem cell transplants
100% Scheme tariff. (PMBs Only).
Major maxillo-facial surgery strictly related to certain conditions
100% Scheme tariff. Limited to R15 658 per family per annum.
Dental and oral surgery (In- or out of hospital)
Limited to R9 768 per family per annum.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R96 384 per family per annum.
Prosthesis – Internal Note: Sub-limits subject to the overall annual prosthesis limit. *Functional: Items used to replace or augment an impaired bodily function.
Sub-limits per beneficiary per annum: *Functional R35 146. Pacemaker (single and dual chamber) R51 998. Vascular R65 898. Spinal including artificial disc R38 208. Drug-eluting stents - subject to Vascular prosthesis limit. Mesh R13 429. Gynaecology/urology R11 091. Lens implants R8 330 a lens per eye.
Exclusions (Prosthesis sub-limit subject to preferred provider, otherwise limits and co-payments apply).
Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits: Hip replacement and other major joints R40 364. Knee replacement R49 944. Other minor joints R15 371
Prosthesis – External
No benefit (PMBs only).
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
Orthopaedic and medical appliances
100% Scheme tariff. Limited to R15 000 per family per annum.
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)
Limited to a combined in and out of hospital benefit of R35 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Oncology
100% Scheme tariff. Subject to pre-authorisation, protocols and DSP.
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 R10 055 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 (i.e. procedures done in the doctor's rooms)
100% Scheme tariff.
Advanced illness benefit
100% Scheme tariff, limited to R69 654 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Day procedures
Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time.
International travel cover
Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA. Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA
GP 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
100% Scheme tariff. Limited to R2 092 per family per annum. Thereafter, savings account
Wound care benefit (incl dressings, negative pressure wound therapy treatment and related nursing services - out-of-hospital)
100% Scheme tariff. Limited to R4 267 per family. Limited to R4 079 per family.
Optometry benefit
Benefits available every 24 months from date of service. Network Provider (PPN): Consultation - One (1) per beneficiary. Frame = R945 covered AND 100% of cost of standard lenses (single vision OR bifocal OR multifocal) OR Contact lenses = R1 710 OR Non-network Provider: Consultation - R400 fee at non-network provider Frame = R709 AND Single vision lenses = R215 OR Bifocal lenses = R460 OR Multifocal lenses limited to R1 040 (consisting of R810 per base lens plus R230 per branded lens add-on). In lieu of glasses members can opt for contact lenses, limited to R1 710 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 a combined in- and out-ofhospital benefit of R35 000 per family per annum. Co-payment of R2 000 per scan, not applicable to PMBs. PET scans - PMB only. Subject to pre-authorisation.
Rehabilitation services after trauma
PMBs only. Subject to pre-authorisation and DSPs.
Managed Healthcare - Back and Neck Preventative Programme
Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs.
Oncology
Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation, protocols and DSP. Subject to pre-authorisation and DSPs.
HIV/AIDS
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
CDL and PMB chronic medicine
100% Scheme tariff. Co-payment of 30% for non-formulary medicine. Co-payment of 30% for non-formulary medicine.
Non-CDL chronic medicine
5 conditions. 80% Scheme tariff. Limited to M = R4 166, M1+ = R8 475. Co-payment of 30% for non-formulary medicine. 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.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits:
Add Dependants
Beat3 Plus offers extensive in-hospital cover with substantial savings and additional out-of-hospital benefits, including supplementary services and optometry 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: R4 848
Adult dependant: R3 485
Child dependant: R1 769
Maximum child dependants: 3
Bestmed members pay for only three child dependants. Any additional children can join as beneficiaries of the Scheme at no additional cost. Dependants under the age of 24 years are regarded as child dependants.
Get personalised pricing
call for more information
