Bestmed Beat 1 Medical Aid Plan
Overall, the Bestmed Beat 1 Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and in-hospital procedures to up to 3 Family Members. The Bestmed Beat 1 Medical Aid Plan starts from R1, 901 ZAR.
| 👤 Main Member Contribution | R1,710 – R1,901 |
| 👥 Adult Dependent Contribution | R1,329 – R1,475 |
| 🍼 Child Dependent Contribution | R720 – R799 |
| 🌎 International Cover | R10 million |
| 🔁 Gap Cover | None |
| 🏥 Hospital Cover | Subject to scheme rules |
| 🏠 Home Care | ☑️ Yes |
| 🪥 Dentistry Benefit | ☑️ Yes |
| 🦷 Advanced Dentistry | ☑️ Yes |
| 📌 HIV Care Program | ☑️ Yes |
Bestmed Beat 1 Review – 6 Key Point Quick Overview
- ☑️ Bestmed Beat 1 Plan Overview
- ☑️ Bestmed Beat 1 Plan Contributions
- ☑️ Bestmed Beat 1 Plan Benefits and Cover Comprehensive Breakdown
- ☑️ Bestmed Beat 1 Plan vs. Similar Plans from other Medical Schemes
- ☑️ Our Verdict on The Bestmed Beat 1 Plan
- ☑️ Bestmed Beat 1 Plan Frequently Asked Questions
Bestmed Beat 1 Plan Overview
The Bestmed Beat 1 medical aid plan is one of 10, starting from R1,901, and includes in-hospital procedures and treatment, medical events, international cover, maternity, and more.
Gap Cover is not available on the Bestmed Beat 1 Plan. Bestmed offers 24/7 medical emergency assistance. According to the Trust Index, Bestmed has a trust rating of 3.5.
Did you know Bestmed offers 9 other plans to choose from e.g. Beat 2, Beat 3, Beat 4
Bestmed Beat 1 Plan Contributions
| 🔎 Member | 👤 Main Member | 👥 +1 Adult Dependent | 💙 +1 Child Dependent |
| 📉 Network | R1,710 | R1,329 | R720 |
| ➡️ Non-Network | R1,901 | R1,475 | R799 |
Bestmed Beat 1 Plan Benefits and Cover Comprehensive Breakdown
Beat 1 Hospital Plan
Only in-hospital cover is provided on Beat 1.
Bestmed Beat 1 In-Hospital Benefits
Method of Payment on Beat 1 Plan:
- ✅ On the Beat 1 option, in-hospital benefits are covered by Scheme risk, but out-of-hospital treatments are the member’s responsibility.
- ✅ The Scheme’s risk-benefit provides some preventative care advantages.
While using DSPs, any benefits related to conditions that meet the requirements for PMBs will be covered.
Bestmed Beat 1 Scheme Benefits for Different Medical Events In-Hospital:
- ✅ Members must get pre-approval for all planned operations at least fourteen (14) days before the event. In emergencies, however, the member, their authorized representative, or the hospital must notify Bestmed of the member’s hospitalization as soon as feasible or on the first business day after admission.
- ✅ Clinical procedures, preferred providers, designated service providers, formularies, funding rules, and the Mediscor Reference Price (MRP) could apply.
A maximum co-payment of R13,078 will apply if a member chooses not to utilize a hospital that is part of a hospital network for the Beat Network benefit option.
| 🏥 In-Hospital Accommodation and fees for the theatre | Covered up to 100% of the Bestmed tariff. |
| 💊 Take-home medication after discharge | Covered up to 100% of the Bestmed tariff.
Limited to a 7-day supply. |
| 💉 Biological medicine (in-hospital) | Annually limited to R10,570 per family.
Subject to pre-approval and financial restrictions. |
| 💙 Treatment in Mental Health Clinics | Covered up to 100% of the Bestmed tariff.
Limited to 21 days per beneficiary yearly. |
| 🧪 Chemical and Substance Abuse Treatment | Covered up to 100% of the Bestmed tariff.
Limited to 21 days or R35,573 per beneficiary per year.
Subject to members using network facilities. |
| 🩺 Consultations and procedures | Covered up to 100% of the Bestmed tariff. |
| ☑️ Surgical Procedures (including anesthetic) | Covered up to 100% of the Bestmed tariff. |
| ❤️ Organ Transplants | Covered up to 100% of the Bestmed tariff.
Only PMBs are covered under this benefit. |
| 😊 Major medical maxillo-facial surgery (Only specified conditions) | Only PMBs are covered at DSP day hospitals. |
| 🦷 In- and Out-of-Hospital Dental and oral surgery | Only PMBs are covered at DSP day hospitals. |
| 🦵 Prostheses are subject to preferred providers or co-payments, and limits will apply | Covered up to 100% of the Bestmed tariff.
There is a limit of p to R86,841 per family. |
🦾 Internal Prostheses (Preferred Providers or limits and co-payments will apply)
Functional items used must be towards treating or supporting bodily functions | The following sub-limits apply per beneficiary
Functional limited to – R31,000
Pacemakers (dual chamber) – R47,344
Vascular – R50,000
Spinal, including artificial discs – R34,661
Drug-eluting stents – only PMBs using DSP products
Mesh – R12,164
Gynecology/Urology – R9,940
Lens Implants (per lens, per eye) – R7,585 |
| ✅ Joint replacement surgery | The following prostheses limits apply to PMBs:
Hip replacement and other major joints – R36,489
Knee replacement – R44,990
Other minor joints – R13,995 |
| 📌 Orthopedic and Medical Appliances | Covered up to 100% of the Bestmed tariff. |
| 📍 Pathology | Covered up to 100% of the Bestmed tariff. |
| 📈 Radiology | Covered up to 100% of the Bestmed tariff. |
| 📉 MRI, CT scans, and other specialized diagnostics | Covered up to 100% of the Bestmed tariff. |
| 📊 Oncology | Covered up to 100% of the Bestmed tariff.
The benefit is subject to pre-authorization and the use of DSP |
| 🚩 Peritoneal Dialysis and hemodialysis | Covered up to 100% of the Bestmed tariff.
The benefit is subject to pre-authorization and the use of DSP |
| 🚼 Birthing Confinements | Covered up to 100% of the Bestmed tariff. |
| 🔍 HIV/AIDS | Covered up to 100% of the Bestmed tariff.
The benefit is subject to pre-authorization and the use of DSP |
| 📌 Refractive Surgery (and all other procedures that aim to improve or stabilize vision, excluding cataracts) | Only PMBs are covered. |
| 🍼 Midwife-assisted birth | Covered up to 100% of the Bestmed tariff. |
| 💊 Supplementary Services | Covered up to 100% of the Bestmed tariff. |
| 🚑 Hospitalization Alternatives | Covered up to 100% of the Bestmed tariff. |
| 🏠 Palliative and Home-Based Care instead of hospitalization | Covered up to 100% of the Bestmed tariff.
There is a limit of R63,420 per beneficiary yearly.
Subject to benefit availability, pre-authorization, and treatment plan. |
| ✳️ Day Procedures performed at a day hospital | Funded at 100% of the Network or Scheme Tariffs if DSPs are used.
There is a co-payment of R2,500 when voluntarily using a non-DSP specialist or hospital. |
| 🌎 International Travel Cover | Leisure Travel: Coverage is limited to 45 days and R500,000 for trips to the United States.
All other nations are insured for up to 90 days, and a family (member and dependents) is protected for R3 million.
Business Travel to the United States is limited to 45 days and covers up to R500,000.
All other nations are insured for up to 45 days, and a family (member and dependents) is protected for R3 million. |
| 🚩 Co-Payments for using a non-network option | Co-payment for the voluntary use of a non-network hospital is R13,078 for the network option. |
Bestmed Beat 1 Out-of-Hospital Benefits
- ✅ The following benefits may be subject to pre-approval, clinical procedures, preferred providers (PPs), designated service providers (DSPs), formularies, funding guidelines, and the Mediscor Reference Pricing (MRP).
- ✅ All planned treatments or procedures must be pre-authorized for members.
Non-network pharmacies and non-network DSP specialists will be reimbursed at the Scheme price, including for treating PMBs, if the member chooses the network option.
| ☑️ Diabetes Primary Care Consultation | Covered up to 100% of the Scheme price.
Subject to HaloCare registration.
Two consultations for primary care at Dis-Chem pharmacies. |
✅ Wound Care Benefit
(Dressings, negative pressure wound therapy NPWT treatment, and other nursing services Out-of-hospital) | Covered up to 100% of the Bestmed tariff.
Limited to R3,885 per family per year. |
| ☑️ Oncology | Oncology program at the full Scheme rate.
Subject to pre-approval and DSP. |
| ✅ Peritoneal Dialysis and Hemodialysis | Covered up to 100% of the Bestmed tariff.
Subject to pre-approval and DSP. |
| ☑️ HIV/AIDS | Covered up to 100% of the Bestmed tariff.
Subject to pre-approval and DSP. |
| ✅ MRI scans, CT scans, and isotope studies | Covered up to 100% of the Bestmed tariff.
Limited to R5,885 per family per year |
| ☑️ Rehabilitation after a traumatic event | Only PMBs are covered.
Subject to pre-approval and DSP. |
Bestmed Beat 1 Medicine
- ✅ The following benefits may be subject to pre-authorization, clinical protocols, preferred providers (PPs), designated service providers (DSPs), formularies, funding criteria, the Mediscor Reference Price (MRP), and the exclusions listed in Annexure C of the published Regulations.
- ✅ Members will not incur co-payments for PMB pharmaceuticals on the formulary for which no generic substitute exists.
Members selecting the network option are required to receive their medications from Scheme-contracted pharmacies.
| 1️⃣ CDL and PMB Chronic Conditions | Covered up to 100% of the Bestmed tariff.
There is a co-payment of 30% for non-formulary medicine. |
| 2️⃣ Biological medicine | Only PMBs are covered according to funding protocols.
Subject to pre-approval. |
| 3️⃣ Other high-cost medication | Only PMBs are covered according to funding protocols.
Subject to pre-approval. |
Bestmed Beat 1 Chronic Condition List
The Bestmed Beat 1 Chronic Condition List and Prescribed Minimum Benefits are as follows:
CDL:
- ✅ Addison’s disease
- ✅ Asthma
- ✅ Bipolar Mood Disorder
- ✅ Bronchiectasis
- ✅ Cardiac Failure
- ✅ Cardiomyopathy
- ✅ Chronic obstructive pulmonary disease (COPD)
- ✅ Chronic Renal Disease
- ✅ Coronary Artery Disease
- ✅ Crohn’s Disease
- ✅ Diabetes Insipidus
- ✅ Diabetes mellitus type 1
- ✅ Diabetes mellitus type 2
- ✅ Dysrhythmias
- ✅ Epilepsy
- ✅ Glaucoma
and many more.
PMB:
- ✅ Aplastic anemia
- ✅ Benign prostatic hypertrophy
- ✅ Cerebral palsy
- ✅ Chronic anemia
- ✅ COVID-19
- ✅ Cushing’s disease
- ✅ Cystic fibrosis
- ✅ Endometriosis
- ✅ Female menopause
- ✅ Fibrosing alveolitis
and many more.
Bestmed Beat 1 Preventative Care
The following benefits could be subject to pre-approval, clinical procedures, preferred providers (PPs), designated service providers (DSPs), formularies, funding guidelines, and the Mediscor Reference Pricing (MRP).
| 🔎 Benefit | 📌 Gender and Age Group | 📉 Quantity and Frequency | ☑️ Criteria |
| 💉 Flu Vaccines | All | 1 per beneficiary yearly | Applies to all active participants and recipients. |
| ✔️ Pneumonia Vaccines | Children <2 Years
High-risk adult group | Children – according to the Department of Health
Adults – Twice in a lifetime with a booster for beneficiaries 65> | Adults: The Scheme will identify high-risk adults who will be encouraged to receive vaccinations. |
| 👶 Baby Growth and Development Assessments | 0 – 2 Years | 3 Assessments per year | Pharmaceutical clinics under the Bestmed Network perform assessments. |
| ✳️ Female Contraceptives | All female beneficiaries of child-bearing age | Depends on the product according to the maximum allowed amount | Annually limited to R2,550 per beneficiary.
Covers all items categorized under the female contraception category. |
| ➡️ HPV Vaccinations | Females 9 – 26 | 3 vaccines per beneficiary | Vaccinations are funded according to the MRP |
| 🔁 Mammogram | All females 40 years> | Once every 2 years | Covered up to 100% of the Bankmed tariff |
| 🔍 Back and Neck Preventative Care Program | All | Subject to pre-authorization | Providers of choice (DBC/Workability Clinics).
This is a prophylactic approach designed to avoid the need for back and neck surgery.
The System could discover suitable volunteers.
Based on the initial evaluation, a rehabilitation treatment plan is developed and implemented over a period indicated by the provider.
This program is an alternative to surgery. |
| 🩺 Pap Smear | Female beneficiaries 18 and older | Once every 24 months | Possible at a gynecologist, family physician, or pharmacy clinic.
The consultation will be at the member’s expense. |
Bestmed Tempo Wellness Program
The Bestmed Tempo wellness program is designed to assist you in enhancing your health and reaping the benefits that come with it. Therefore, members can access the following advantages:
| 🔎 Temporary Health Assessment (HA) for adults (16 years and older) that includes one of the following per adult beneficiary per year | The Tempo lifestyle questionnaire
Blood pressure check
Cholesterol check
Glucose check
Height, weight, and waist circumference
These assessments must be conducted at a contracted pharmacy or on-site at employer groups participating in the program. |
| 📍 Bestmed Tempo Fitness and Nutrition Programs (for those older than 16) | Fitness
1 x (face-to-face) fitness assessment with a Tempo partner biokinetics.
1 x (virtual or face-to-face) follow-up discussion to receive a customized fitness/exercise plan from a Tempo partner biokinetics.
These fitness benefits are designed to support your Tempo Get Active journey.
Nutrition
1 x (in-person) nutrition evaluation with a Tempo partner dietician
1 x follow-up (virtual or in-person) consultation with a Tempo partner dietician to receive your personalized healthy-eating plan.
These nutritional benefits are designed to support your Tempo Nutritional Health Journey. |
| 💙 Emotional wellness journey | Licensed psychologists and healthcare professionals designed this to help you understand and manage your emotions and their impact on your mental health.
In addition, this Adventure grants you access to the following:
Lifestyle-related knowledge that will assist you in adapting to life’s alterations and surprises.
Practical obstacles that will allow you to practice the new abilities you must acquire to evolve from your current emotional and mental state to the state you seek. |
| 🍼 Maternity Benefits | Covered up to 100% of the Scheme tariff. Depending on the following benefits:
Consultations
Six prenatal consultations with a general practitioner, gynecologist, or midwife.
Ultrasounds
1 x 2D ultrasound scan in the first trimester (between 10 and 12 weeks) performed by an FP OR gynecologist OR radiologist.
1 x 2D ultrasound scan in the second trimester (between 20 and 24 weeks) performed by an FP OR gynecologist OR radiologist. |
Bestmed Beat 1 Maternity Care Program
The Maternity care program is available to pregnant members and their dependents, providing them with comprehensive services and information.
It has been designed with expectant parents’ specific needs and support networks.
It provides support, education, and advice throughout pregnancy, confinement, and the postnatal period.
Try our free Ovulation Calculator
To access these services, members must register for the Bestmed Maternity care program when they receive confirmation of their pregnancy through a pathology test or scan from their family practitioner or gynecologist.
Once registration is complete, a consultant will reach out to them.
You might also consider: Health Insurance for Pregnancy
Bestmed Beat 1 Plan Exclusions and Waiting Periods
Bestmed Beat 1 Exclusion
Some of the following are excluded from Beat 1. The comprehensive list can be found on the official Bestmed website.
- ✅ Any fees associated with patient and medical staff travel.
- ✅ Medical aids, orthopedic, surgical, and medical appliances, excluding those described in Annexes B.1 to B.4 of the Scheme Regulations and those prescribed for treating specific PMB disorders and available in the public sector.
- ✅ Requested reports, examinations, tests for emigration, immigration, visas, insurance policies, employment, admission to schools and universities, court medical reports, muscle-function tests, fitness examinations and testing, adoption of children, and retirement due to ill health.
- ✅ Any non-functional or cosmetic procedures, operations, or treatments.
- ✅ Accounting for services performed by individuals not registered with the Health Professionals Council of South Africa, the Associated Health Service Professions Board, or a comparable healthcare organization in the nation where the service was rendered.
Finally, Unkept appointments by members, and more.
Bestmed Beat 1 Waiting Periods
Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Bestmed Beat 1 plan:
- ✅ A 3-month general waiting period in respect of all benefits.
- ✅ A 12-month exclusion in respect of a pre-existing condition.
A late-joiner contribution penalty does apply.
Bestmed Beat 1 Plan vs. Similar Plans from Other Medical Schemes
| 🌎 International Cover | R10 million | R5 million | None |
| 👤 Main Member Contribution | R1,710 – R1,901 | R1,923 | R930 – R2,190 |
| 👥 Adult Dependent Contribution | R1,329 – R1,475 | R1,446 | R930 – R2,190 |
| 🍼 Child Dependent Contribution | R720 – R799 | R771 | R560 – R670 |
| 🔁 Gap Cover | None | ☑️ Yes | ☑️ Yes |
| 💶 Prescribed Minimum Benefits (PMB) | ✅ Yes | ✅ Yes | ✅ Yes |
| ⚕️ Screening and Prevention | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| 🦷 Dentistry Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 💙 Mental Healthcare Program | ☑️ Yes | ☑️ Yes | ☑️ Yes |
| ➡️ Diabetes Care Program | ✅ Yes | ✅ Yes | ✅ Yes |
Our Verdict on The Bestmed Beat 1 Plan
Bestmed Beat 1 is a comprehensive option that covers in-hospital and day-to-day medical expenses. In addition, it includes chronic medication coverage, preventative care benefits, and a maternity program.
Bestmed offer easy procedures to make fast and efficient claims.
However, there are some drawbacks to Bestmed Beat 1. One of the main ones is that it may be more expensive than other options from Bestmed.
You might also consider the following options BestMed has to offer:
Frequently Asked Questions
What kind of cover does Bestmed Beat 1 offer?
Bestmed Beat 1 is a comprehensive option that covers in-hospital and day-to-day medical expenses. In addition, it includes chronic medication coverage, preventative care benefits, and a maternity program.
What are the Bestmed Beat 1 dental benefits?
Bestmed Beat 1 covers dental and oral surgery in and out-of-hospital.
How much is Bestmed Beat 1 monthly?
The Bestmed Beat 1 option is an entry-level plan from R1,710 monthly.
Is Bestmed Beat 1 a hospital plan?
No, Bestmed Beat 1 is not a hospital plan. However, on the Beat1 option, in-hospital benefits are covered by Scheme risk.
Does Bestmed Beat 1 have a network of healthcare providers?
Yes, members of Bestmed Beat 1 have access to a network of healthcare providers, including hospitals, doctors, and specialists.
Is Bestmed Beat 1 expensive?
No, Bestmed Beat 1 is an entry-level plan and cheaper than other options available from Bestmed.
What benefits are included in Bestmed Beat 1?
Bestmed Beat 1 includes a range of benefits, including comprehensive coverage, chronic medication cover, preventative care benefits, and a maternity program.
Are there any limits on benefits with Bestmed Beat 1?
Yes, there may be limits on certain benefits with Bestmed Beat 1, which could impact members who require a lot of medical care.
Does Bestmed Beat 1 cover preventative care?
Yes, Bestmed Beat 1 includes preventative care benefits, which can help members to maintain good health and manage chronic conditions effectively.
Does Bestmed Beat 1 cover maternity expenses?
Bestmed Beat 1 includes a maternity program providing comprehensive information and services for expectant parents and their support networks.
