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The Bestmed rules changes taking effect from 1 January 2022 have been published. The changes are regarding option benefit enhancements and increased contributions, let’s have a look at what this means for you.

Co-payments

On the Beat range we have removed the co-payment of R3 800 on endoscopic investigations and specialised diagnostic imaging. We have also removed the co-payment for the specialised diagnostic imaging on Beat3 and Beat3 Network benefit.

The co-payment on the Beat Network benefit options for the voluntary use of a non-designated hospital network changes from R11 874 to R12 373.

On the Pulse range we have removed the co-payment on all laparoscopic procedures, prostate procedures, prolapsed / incontinence, arthroscopy other than acute trauma and endoscopic investigations for Pulse1 of R3 800. We have also removed of R500 co-payment for non-referred specialist visits on the Pulse1 benefit option.

The co-payment on the Pulse benefit option for the voluntary use of a non-designated hospital network changes from R11 874 to R12 373.

Maternity benefits

The maternity benefits have been removed from the Bestmed Tempo wellness programme, but to remain under the preventative care benefits.

• We have also added lactation consultation with a registered nurse or lactation specialist on all benefit options.
• There is also a limit increase from R100 to R120 for the maternity supplement on the Beat3, Beat4, Pace1, Pace2, Pace3, Pace4 and Pulse1 benefit options.

Preventative Care Benefits

• Baby growth and development assessments have been added to all benefit options on the Beat range, Pace range and the Pulse range
• Female contraceptives benefit now applies per beneficiary and the limit will increase across all benefit options from R2 315 to R2 412.
• The Mammogram benefit will be added to Beat1 and Beat1 Network benefit options.
• The qualifying age for Bestmed Tempo Health Assessments has changed to from 18 years to 16 years.

Rehabilitation after trauma

We have added a rehabilitation after trauma benefit to pay PMB conditions on the Beat1, Beat1 Network and Pulse1 benefit options. We also changed the benefit to be paid from the risk (PMB conditions) instead of the medical savings account for the Beat2, Beat2 Network, Beat3 and Beat3 Network benefit options and the benefit will be paid from the risk instead of the vested medical savings account for the Beat4 and Pace1 benefit options.

Important note

This article of the rule changes is given for information purposes only. Should there be any errors or omissions contained herein, the registered Rules of Bestmed, as approved by the Registrar of Medical Schemes, shall prevail.

All information regarding the 2022 benefit options and accompanying services, including information in respect of the terms and conditions, or any other matters, is subject to prior approval of the Council for Medical Schemes (CMS) and may change without notice, having due regard to the CMS’ further advice.

The document, along with the full 2022 Scheme rules, are also available on the Bestmed website via the link below:

https://www.bestmed.co.za/about-bestmed/scheme-rules