No matter your age, if you are looking to be covered for life’s unexpected tumbles, our hospital plans give unlimited cover for planned and unplanned hospital stays.
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff. Limited to 7 days' medicine
Biological medicine during hospitalisation
Limited to R11 099 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 R37 352 per beneficiary. Subject to network facilities.
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 at DSP day hospitals.
Dental and oral surgery (In- or out of hospital)
PMBs only at DSP day hospitals.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R91 183 per family per annum.
Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Items utilised towards treating or supporting a bodily function
Sub-limits per beneficiary:
*Functional R32 550
Pacemaker (dual chamber) R49 711
Vascular R52 500
Endovascular and catheter-based procedures - no benefit
Spinal incl. artificial disk R36 394
Drug-eluting stents - PMBs and DSP products only
Mesh R12 772
Gynaecology/Urology R10 437
Lens implants R7 964 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 apply. Preferred provider network available.)
Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
Hip replacement and other major joints R38 313
Knee replacement R47 240
Minor joints R14 695
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 and DSP.
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Confinements (Birthing)
100% Scheme tariff.
HIV and AIDS
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)
PMBs only
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 R66 591 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. A co-payment of R2 625 will be incurred per event if a day procedure is voluntarily done by a non-DSP provider, or if the procedure is done in an acute hospital that is not a day hospital. If the provider is a DSP and does not work in a day hospital, the procedure will be paid in full if it is done in an acute hospital.
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 R3 million for a family i.e. 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 R3 million for a family i.e. member and dependants.
Co-payments
Co-payment for voluntary use of non-network hospital R13 732 for Beat1 Network option.
Family Practitioner (FP) and specialist consultations
None.
Medical Savings
None.
Medical aids, apparatus and appliances including wheelchairs and hearing aids (Hearing aids are subject to pre-authorisation)
None.
Supplementary services
None.
Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)
100% Scheme tariff. Limited to R4 079 per family.
Basic and Specialised Dentistry
None.
Optometry Services
None.
Basic radiology and pathology
None.
Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans excluded)
100% Scheme tariff. Limited to R6 179 per family. Limited to one (1) scan per lumbar and cervical spine region per beneficiary per annum.
Oncology
Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
HIV/AIDS
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. Subject to pre-authorisation
Other high-cost medicine
PMBs only as per funding protocol. Subject to pre-authorisation
Acute medicine
No benefit.
Over-the-counter (OTC) medicine
No benefit.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits
Add Dependants
No matter your age, if you are looking to be covered for life's unexpected tumbles, our hospital plans give unlimited cover at any of our network hospitals for planned and unplanned hospital stays.
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 873
Adult dependant: R1 456
Child dependant: R789
Maximum child dependants: 3
Bestmed members pay for only three child dependants. The rest is covered at no extra cost. 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 
Accommodation (hospital stay) and theatre fees
100% Scheme tariff.
Take-home medicine
100% Scheme tariff. Limited to 7 days' medicine
Biological medicine during hospitalisation
Limited to R11 099 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 R37 352 per beneficiary. Subject to network facilities.
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 at DSP day hospitals.
Dental and oral surgery (In- or out of hospital)
PMBs only at DSP day hospitals.
Prosthesis (Subject to preferred provider, otherwise limits and co-payments apply)
100% Scheme tariff. Limited to R91 183 per family.
Prosthesis – Internal Note: Sub-limit subject to the overall annual prosthesis limit. *Functional: Items utilised towards treating or supporting a bodily function
Sub-limits per beneficiary:
*Functional R32 550
Pacemaker (dual chamber) R49 711
Vascular R52 500
Endovascular and catheter-based procedures - no benefit
Spinal incl. artificial disk R36 394
Drug-eluting stents - PMBs and DSP products only
Mesh R12 772
Gynaecology/Urology R10 437
Lens implants R7 964 a lens per eye
Prosthesis – External
No benefit. (PMBs only).
Exclusions (Limits and co-payments apply. Preferred provider network available.)
Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits:
Hip replacement and other major joints R38 313
Knee replacement R47 240
Minor joints R14 695
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.
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 and DSP.
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Confinements (Birthing)
100% Scheme tariff.
HIV and AIDS
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Refractive surgery and all types of procedures to improve or stabilise vision (except cataracts)
PMBs only
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 R66 591 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. A co-payment of R2 625 will be incurred per event if a day procedure is voluntarily done by a non-DSP provider, or if the procedure is done in an acute hospital that is not a day hospital. If the provider is a DSP and does not work in a day hospital, the procedure will be paid in full if it is done in an acute hospital.
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 R3 million for a family i.e. 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 R3 million for a family i.e. member and dependants.
Co-payments
Co-payment for voluntary use of non-network hospital R13 732 for Beat1 Network option.
Family Practitioner (FP) and specialist consultations
None.
Medical Savings
None.
Medical aids, apparatus and appliances including wheelchairs and hearing aids (Hearing aids are subject to pre-authorisation)
None.
Supplementary services
None.
Wound care benefit (incl. dressings, negative pressure wound therapy -NPWT- treatment and related nursing services -out-of-hospital)
100% Scheme tariff. Limited to R4 079 per family.
Basic and Specialised Dentistry
None.
Optometry Services
None.
Basic radiology and pathology
None.
Specialised diagnostic imaging (Including MRI scans, CT scans and isotope studies. PET scans excluded)
100% Scheme tariff. Limited to R6 179 per family. Limited to one (1) scan per lumbar and cervical spine region per beneficiary per annum.
Oncology
Oncology programme at 100% of Scheme tariff. Subject to pre-authorisation and DSP.
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
HIV/AIDS
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. Subject to pre-authorisation
Other high-cost medicine
PMBs only as per funding protocol. Subject to pre-authorisation
Acute medicine
No benefit.
Over-the-counter (OTC) medicine
No benefit.
Children:
Adults:
Adults:
100% Scheme tariff. Subject to the following benefits
Add Dependants
No matter your age, if you are looking to be covered for life's unexpected tumbles, this hospital plan gives unlimited cover for unplanned hospital stays.
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 082
Adult dependant: R1 616
Child dependant: R875
Maximum child dependants: 3
Bestmed members pay for only three child dependants. The rest is covered at no extra cost. 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
