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Many of us hoped that by the time we ushered in the new year COVID-19 would be a thing of the past but unfortunately this is not the case, yet. Spring and summer festivities have left us at the mercy of the second wave and with the virus mutation and the rising numbers, we are just as uncertain about the future now, as we were in March 2020. As such, it is important that we continuously monitor the outbreak, and keep our members in the know so that you have the information you need to make the best healthcare decisions for you and your dependants. We have updated our cover to ensure that we fully meet our members’ COVID-19 related medical needs.

We offer:

OUT-OF-HOSPITAL BENEFITS:

COVID-19 Testing Protocol

As per the Council for Medical Schemes’ (CMS) guidelines, Bestmed will fund screening consultations and pathology tests as a prescribed minimum benefit (PMB) from the Scheme risk benefit, whether the test is negative or positive where members comply with both the parameters listed below:

• The member shows symptoms of COVID-19, and/or was in contact with individuals with the virus; and
• The member was referred by a healthcare worker (doctor or nurse).

If a member is asymptomatic and is not referred by a healthcare worker, consultations and pathology tests will be paid from the relevant Scheme benefits according to their option rules and benefit availability.

Physical, Telephonic and Video Consultations

We require that members obtain a referral by a medical professional before taking a COVID-19 test. Members are encouraged to take the required safety precautions when visiting their provider, and to keep in mind that Bestmed also covers telephonic and video consultations with healthcare providers during the national lockdown. Telephonic and video consultations will be paid in accordance with benefit provision as per the member’s selected Bestmed option, or from Scheme risk as a PMB in line with the parameters listed above.

Over-The-Counter Benefits

Bestmed members can also claim refunds for any cash purchases of hand sanitisers and masks purchased from any network pharmacy by sending the proof of purchase to claims@bestmed.co.za. Refunds are paid from the member’s available over-the-counter (OTC) benefit. We have communicated this update to our members and hope that together, we can allay some of the fears that are natural at this time.

Contact Channels During National Lockdown

Bestmed recognises the importance of assuring you and your dependants that we have taken all the necessary steps to ensure that our role as the funder of all your healthcare needs remains intact during the national lockdown. This means that Bestmed members are still able to access their benefits, submit chronic applications, request pre-authorisation, visit core network service providers, and communicate with our Contact Centre to resolve queries. In adherence to the social distancing requirements, we encourage our members to make use of our self-service and contact-less support facilities as listed below: