Find the answers to your most burning questions right here!
An MSA is a benefit account established in the name of the principal member concerned.
The MSA is calculated using a fixed percentage of the total contribution.
Medical expenses for out-of-hospital services are paid from an MSA if available on the chosen option.
These funds are available from the beginning of the year or prorated if the Scheme was joined during the year.
No, not all plan options have a Medical Savings Account. The Pulse and Beat1 options do not include a Medical Savings Account.
You first utilise the Medical Savings Account. Once it is depleted, you will have access to your day-to-day benefits on specific plan options.
On Beat4, Pace1, Pace2 and Pace3 your day-to-day benefits will become available.
No, the MSA does not fund co-payments.
No, you don’t lose it. It becomes a part of the following year's savings or will be added to your vested savings, depending on your benefit option.
Yes. The Scheme allocates the net interest received on Medical Savings Account invested funds to members with positive savings balances.
The money will be transferred for you to use the following year. If you resign your membership with Bestmed and choose not to join another scheme, or if you join a scheme without a savings option, the money will be paid to you. If you join a scheme with a savings account, the money will be transferred into the new scheme's medical savings account if a principal member joins another scheme with an MSA option.
Vested savings are accumulated savings from previous years.
Members may request payment of services such as co-payments, certain excluded medicine items and fees above Scheme tariff to be paid from their vested savings, depending on their benefit option.
Yes. Members may apply to the Scheme to use their vested savings to pay for additional benefits, such as tinted glasses.
Costs relating to PMB services, or the self-payment gap, cannot be paid from vested savings.
Members can give permission to pay for claims from the vested savings account. Some claims are automatically paid from vested savings.
The principal member will receive the balance of funds, including interest earned.
A co-payment is the portion of a claim payable by the member directly to the healthcare provider.
Please note that according to the Council for Medical Schemes (CMS), co-payments may not be deducted from your savings account or vested savings account or reimbursed to you. The co–payment percentage varies according to the different benefit options. The table below highlights the different co–payments applicable per Scheme option for the CDL, PMB and non–CDL conditions:
|BENEFIT||Non-formulary co-payment for CDL and PMB medicine||Formulary co-payment for Non-CDL conditions||Non-formulary co-payment for Non-CDL conditions|
|BEAT1 / BEAT1 N||40%||N/A||N/A|
|BEAT2 / BEAT2 N||40%
|BEAT3 / BEAT3 N||40%||20%