Overall, the Bestmed Beat 4 Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and in-hospital procedures for its members. The Bestmed Beat 4 Medical Aid Plan starts from R6,832 ZAR.
π International Holiday and Business Cover | R5million per family limited to 90 days and limit to 1Million in USA per family. |
π€ Main Member Contribution | R6,832 ZAR |
π₯ Adult Dependent Contribution | R5,642 ZAR |
π Child Dependent Contribution | R1,689 ZAR |
π Optometry Benefit | βοΈ Yes |
πΆ Prescribed Minimum Benefits (PMB) | βοΈ Yes |
π Screening and Prevention | βοΈ Yes |
π³ Medical Savings Account | βοΈ Yes |
πΌ Maternity Benefits | βοΈ Yes |
π Hospital Cover | Unlimited |
The Bestmed Beat 4 medical aid plan is one of 14 plans, starting from R6, 832 and includes an international cover of up to R5 million but only R1 million in USA Family cover, out-of-hospital benefits, trauma, rehabilitation, and more.
Gap Cover is not available on the Bestmed Beat 4 Plan.
Bestmed offers 24/7 medical emergency assistance and,Β BestmedΒ received the top honours in the Medical Aid Companies category at the latest Ask Afrika Orange Index Awards.
π Download the latest Beat 4 Product Brochure in PDF format.
π€ Main Member | π₯ +1 Adult Dependent | πΌ +1 Child Dependent |
R6,832 | R5,642 | R1,689 |
π€ Main Member | π₯ +1 Adult Dependent | πΌ +1 Child Dependent |
R956 x 12 Months | R790 x 12 Months | R237 x 12 Months |
Poll: 10 Best Medical Aids in South Africa
Savings Account / Day-to-day Benefits
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Method of Payment on Beat 4 Plan
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Benefits for conditions that satisfy PMB requirements will be covered in full while utilizing DSPs. Furthermore, this will not impact your savings (annual or vested).
Bestmed Beat 4 Scheme Benefits for different Medical Events In-Hospital
Clinical procedures, preferred providers, designated service providers, formularies, funding rules, and the Mediscor Reference Price (MRP) could apply.
π In-Hospital Accommodation and fees for the theatre | Covered up to 100% of the Bestmed tariff. |
π Take-home medication after discharge | 100% Scheme tariff if claimed on the day of discharge. Limited to: β’ A maximum of 7 days treatment if claimed as part of the hospital account, or β’ R150 if claimed from a retail pharmacy on the date of discharge. No benefit if not claimed on the date of discharge. |
πͺ₯ Biological medicine (in-hospital) | Limited to R29 022 per family per annum. Subject to pre-authorisation and funding guidelines. |
π Treatment in Mental Health Clinics | Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per financial year in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per financial year. Subject to pre-authorisation. |
π Chemical and Substance Abuse Treatment | Benefits shall be limited to the treatment of PMB conditions and subject to the following: β’ Pre-authorisation β’ DSPs β’ 21 daysβ stay for in-hospital management per beneficiary per annum. |
βοΈ Consultations and procedures | Covered up to 100% of the Bestmed tariff. |
β³οΈ Surgical Procedures (including anesthetic) | Covered up to 100% of the Bestmed tariff. |
β€οΈ Organ Transplants | Covered up to 100% of the Bestmed tariff. (PMB’s only) |
π Major medical maxillo-facial surgery (Only specified conditions) | 100% Scheme tariff. Limited to R15 945 per family per annum. |
π In- and Out-of-Hospital Dental and oral surgery | Limited to R12 210 per family per annum. |
𦡠Prostheses are subject to preferred providers or co-payments, and limits will apply | 100% Scheme tariff. Limited to R117 652 per family per annum. |
π¦Ύ Internal Prostheses (Preferred Providers or limits and co-payments will apply) Functional items used must be towards treating or supporting bodily functions | Sub-limits per beneficiary per annum: β’ *Functional R37 342. β’ Pacemaker (single and dual chamber) R68 086. β’ Vascular R71 390. β’ Spinal including artificial disc R40 652. β’ Drug-eluting stents R22 839. β’ Mesh R15 083. β’ Gynaecology/urology R11 061. β’ Lens implants R8 618 a lens per eye. |
βοΈ External prostheses | Limited to R28 297 per family. DSPs apply. Includes artificial limbs limited to one (1) limb every 60 months. Repair work to artificial limbs will be funded from the out-of-hospital Medical aids, apparatus and appliances benefit. |
β Exclusions (Prosthesis sub-limits form part of overall Internal prosthesis limit subject to preferred provider, otherwise limits and co-payments apply). | Joint replacement surgery (except for PMBs). PMBs subject to prosthesis limits: β’ Hip replacement and other major joints R41 800. β’ Knee replacement R55 532. β’ Other minor joints R17 063. |
π Orthopedic and Medical Appliances | Covered up to 100% of the Bestmed tariff. Limited to R15 000 per family per annum. |
β¬οΈ Pathology | Covered up to 100% of the Bestmed tariff. |
π Radiology | 100% Scheme tariff. |
π MRI, CT scans, and other specialized diagnostics | Limited to a combined in- and out-of hospital benefit of R40 000 per family per annum. Co-payment of R2 000 per scan on MRI and CT scans, not applicable to PMBs. PET scans are limited to one (1) scan per beneficiary per annum, not subject to the abovementioned limit and co-payment. Subject to pre-authorisation. |
π Oncology | Covered up to 100% of the Bestmed tariff. The benefit is subject to pre-authorization and the use of DSP |
π °οΈ Peritoneal Dialysis and hemodialysis | Covered up to 100% of the Bestmed tariff. The benefit is subject to pre-authorization and the use of DSP |
π ±οΈ Birthing Confinements | Covered up to 100% of the Bestmed tariff. |
π₯+πͺOut of hospital benefits. Overall day-to-day limit | M + R14831, M1+ = R29661 |
π©Έ HIV/AIDS | Covered up to 100% of the Bestmed tariff. The benefit is subject to pre-authorization and the use of DSP |
π©Ί Refractive Surgery (and all other procedures that aim to improve or stabilize vision, excluding cataracts) | 100% Scheme tariff. Subject to pre-authorisation and protocols. Limited to R11 349 per eye. |
π§ͺ Midwife-assisted birth | Covered up to 100% of the Bestmed tariff. |
π Supplementary Services | Savings first.Covered up to 100% of the Bestmed tariff. |
π Hospitalization Alternatives | Covered up to 100% of the Bestmed tariff. |
βοΈ Palliative and Home-Based Care instead of hospitalization | 100% Scheme tariff, limited to R104 482 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan. |
β Day Procedures performed at a day hospital | Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs.. A co-payment of R2 746 shall be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the procedure shall be paid in full if it is done in an acute hospital, if it is arranged with the Scheme before the time. |
π International Travel Cover | Leisure Travel: Coverage is limited to 90 days and R5000 000 per family. Business Travel to the United States is limited to 60 days and covers up to R1000 000 per family. All other nations are insured for up to 60 days, and a family (member and dependents) is protected for R5 million per family. |
The following benefits may be subject to pre-approval, clinical procedures, preferred providers, designated service providers (DSPs), formularies, financing guidelines, and the Mediscor Reference Pricing (MRP).
If you have a treatment plan for a Chronic Disease List (CDL) or Prescribed Minimum Benefit (PMB) condition/s, the services in the treatment plan will be paid for first from the applicable day-to-day limit. After the limit has been exhausted, claims will continue to be paid from Scheme risk up to the maximum amount indicated in the treatment plan.
π Overall day-to-day limits | Main Member β R15,513 Main Member + Dependents β R31,025 |
β‘οΈ FP and Specialist Consultations | Savings first. Limited to M = R3 951, M1+ = R7 037. (Subject to overall day-to-day limit) |
1οΈβ£ Basic and Specialized Dentistry | Savings and then from day-to-day limit. Orthodontics are subject to pre-authorisation. Limited to M = R6 835, M1+ = R13 728. (Subject to overall day-to-day limit) |
2οΈβ£ Medical devices/aids, apparatus, appliances (including wheelchairs, crutches, etc.) | Savings first. Limited to R13 934 per family. Includes repairs to artificial limbs. 100% Scheme tariff. (Subject to overall day-to-day limit). |
3οΈβ£ Hearing Aids | Subject to pre-approval. Limited to R12 770 per family every 24 months. 100% Scheme tariff. (Subject to quotation, motivation and audiogram) |
4οΈβ£ Supplementary Services | Covered from available savings first. Limited to M = R6 033, M1+ = R12 253. (Subject to overall day-to-day limit) |
5οΈβ£ Wound Care Benefit (Dressings, negative pressure wound therapy NPWT treatment, and other nursing services Out-of-hospital) | Covered from available savings first. Limited to R6 033 per family. Covered up to 100% of the Bestmed tariff. |
6οΈβ£ Optometry | Benefits available every 24 months from date of service. Network Provider (PPN) β’ Consultation – One per beneficiary. β’ Frame = R1 210 covered AND β’ 100% of cost of standard lenses (single vision OR bifocal OR multifocal) OR β’ Contact lenses = R2 025 OR Non-network Provider β’ Consultation – R400 fee at non-network provider β’ Frame = R908 AND β’ Single vision lenses = R215 OR β’ Bifocal lenses = R460 OR β’ Multifocal lenses = R1 040 (consisting of R810 per base lens plus R230 per branded lens add-on) In lieu of glasses members can opt for contact lenses, limited to R2 025. |
7οΈβ£ Basic Radiology and Pathology | Covered from available savings first. Subject to the overall day-to-day limit. The following limits apply: Main Member β R3 950 Main Member + Dependents β R8 044. |
8οΈβ£ Oncology | Oncology program at the full Scheme rate. Subject to pre-approval and DSP. |
9οΈβ£ Peritoneal Dialysis and Hemodialysis | Covered up to 100% of the Bestmed tariff. Subject to pre-approval and DSP. |
πBack and neck preventative programme | Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs. |
β‘οΈ HIV/AIDS | Covered up to 100% of the Bestmed tariff. Subject to pre-approval and DSP. |
β‘οΈ MRI scans, CT scans, and isotope studies | 100% Scheme tariff. Limited to a combined in- and out-of hospital benefit of R40 000 per family per annum. Co-payment of R 2 000 per scan, not applicable to PMBs. PET scans are limited to one (1) scan per beneficiary per annum. Not subject to the abovementioned limit and co-payment. Subject to pre-authorisation. |
β‘οΈ Rehabilitation after a traumatic event | Covered up to 100% of the Bestmed tariff. |
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.
π CDL and PMB Chronic Conditions | Covered up to 100% of the Bestmed tariff. There is a co-payment of 20% for non-formulary medicine. |
π Non-CDL Chronic medicine (First paid from the non-CDL limit. After that, approved CDL and PMB medicine is paid from the Scheme Risk) | 9 conditions. 90% Scheme tariff. Limited to M = R9 150, M1+ = R18 301. Co-payment of 20% for non-formulary medicine. |
βοΈ Biological medicine | Only PMBs are covered according to funding protocols. Subject to pre-approval. |
β Other high-cost medication | Covered up to 100% of the Bestmed tariff. |
β³οΈ Acute Medicine | Savings funds are used first, then covered up to (subject to the overall day-to-day-limit): Main Member β R3 491 Main Member + Dependents β R7 051 |
βοΈ OTC Medication | Members can choose an R1,161 limit per family. Alternatively, access is given to a full savings account for OTC medicine after the R1,161 limit. This will lead to a self-payment gap accumulation. This benefit includes vitamins, minerals, and sunscreen with Nappi codes on the Bestmed formulary. This benefit is subject to available savings funds. |
The Bestmed Beat 4 Chronic Condition List and Prescribed Minimum Benefits are as follows:
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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).
π Benefit | βοΈ Gender and Age Group | π Quantity and Frequency | π Criteria |
π Flu Vaccines | All | 1 per beneficiary yearly | Applies to all active participants and recipients. |
β Pneumonia Vaccines | Children <2 Years High-risk adult group | Children β according to the Department of Health Adults β 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. |
π Travel Vaccines | All | Amount and frequency vary by product up to the maximum quantity authorized. | Program risk benefits for mandatory typhoid, yellow fever, tetanus, meningitis, hepatitis, and cholera travel vaccinations. |
πΆ Baby Growth and Development Assessments | 0 β 2 Years | 3 Assessments per year | Pharmaceutical clinics under the Bestmed Network perform assessments. |
π©Ί Female Contraceptives | All female beneficiaries of child-bearing age | Depends on the product according to the maximum allowed amount | Annually limited to R2,678 per beneficiary. Covers all items categorized under the female contraception category. |
β³οΈ Intrauterine device (IUD) insertion | All female beneficiaries of child-bearing age | 1 device every 5 years | Consultation and treatment by a gynecologist or family physician. |
π HPV Vaccinations | Female Beneficiaries 9 β 26 | 3 vaccines per beneficiary | Vaccinations are funded according to the MRP |
π Mammogram | All females 40 years> | Once every 2 years | Covered up to 100% of the Bankmed tariff |
βοΈ PSA Screening | Males 50 years and older | Once every 2 years | It may be performed at a urologist, family practitioner, or network pharmacy clinic. The available savings account covers the consultation fee. |
β 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. |
π© Pap Smear | Female beneficiaries 18 and older | Once every 2 years | Possible at a gynecologist, family physician, or pharmacy clinic. The consultation will be at the memberβs expense. |
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The following services may be subject to pre-approval, clinical protocols, and financial guidelines.
π Service | βοΈ Age | π Frequency |
1οΈβ£ General full-mouth examination by a general dentist (including the use of gloves and sterile equipment) | 12 years> | Once yearly |
2οΈβ£ General full-mouth examination by a general dentist (including the use of gloves and sterile equipment) | <12 years | Twice yearly |
3οΈβ£ Full-mouth Intra-Oral Photos | All | Once every 3 years |
4οΈβ£ Intra-Oral Radiograph | All | 2 photos yearly |
5οΈβ£ Scaling or polishing | All | Twice yearly |
6οΈβ£ Fluoride treatment | All | Twice yearly |
7οΈβ£ Fissure Sealing | Up to and including beneficiaries 21 years old | According to the applicable and accepted protocol |
8οΈβ£ Space Maintainers | During the primary and mixed denture stage | Once per space |
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:
π 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. |
π 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. |
βοΈ 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 lifeβs 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. |
β Maternity Benefits | Covered up to 100% of the Scheme tariff. Depending on the following benefits: Consultations Nine prenatal consultations with a general practitioner, gynecologist, or midwife. One postnatal consultation 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. Supplements Any item classified as a pregnancy supplement may be claimed up to a monthly limit of R139 for a maximum of nine months. |
The Maternity care program is available to pregnant members and their dependents, providing comprehensive services and information.
It has been designed with expectant parentsβ specific needs and support networks. It provides support, education, and advice throughout pregnancy, confinement, and the postnatal period.
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.
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Bestmed Beat 4 Exclusions
Some of the following are excluded from Beat 4. The comprehensive list can be found on the official Bestmed website.
Unkept appointments by members, and more.
Bestmed Beat 4 Waiting Periods
Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Bestmed Beat 4 plan:
A late-joiner contribution penalty will apply.
π Medical Aid Plan | π₯ Bestmed Beat 4 (2025) | π₯ Momentum Extender Plan (2024) | π₯ Bonitas BonClassic Plan (2024) |
π International Cover | Up to R5 million and R1 million in USA | Up to R8 million | R10 million |
π€ Main Member Contribution | R6,832 | R5,544 | R6,732 |
π₯ Adult Dependent Contribution | R5,642 | R4,997 | R5,780 |
π Child Dependent Contribution | R1,689 | R1,937 | R1,662 |
π Gap Cover | None | βοΈ Yes | βοΈ Yes |
π Annual Limit | Several limits and sub-limits | None | Unlimited Hospital Cover |
π₯ Hospital Cover | Unlimited | Unlimited | Unlimited |
πΆ Prescribed Minimum Benefits (PMB) | β Yes | β Yes | β Yes |
π» Screening and Prevention | βοΈ Yes | βοΈ Yes | βοΈ Yes |
Overall, Bestmed Beat 4 is a healthcare plan designed to offer value to young or middle-aged families with specific healthcare needs.
In addition, compared to Beat 1, Beat 2 plus Beat 3 Plans, Beat 4 offers higher overall annual limits for specific benefits.
You might also consider the following options BestMed has to offer:
Bestmed Beat 4 offers several advantages over other Beat plans, including higher overall annual limits and limits for specific benefits.Β Furthermore, Beat 4 includes more extensive in-hospital cover, additional benefits like emergency medical transportation, and the flexibility to choose healthcare providers. However, the plan also comes with a higher premium.
Yes, pre-operative consultations and diagnostic testing are covered under the plan.
Yes, Bestmed Beat 4 Medical Aid covers Medical Apparatus and Appliances like Hearing Aids (Hearing aids are subject to pre-authorisation) Savings will be used first. 100% Scheme tariff. Limited to R12 770 per family. (Subject to overall day-today limit)
No, Bestmed Beat 4 does not have a designated network of hospitals. Members can use the hospital of their choice but must follow the Bestmed protocol whenever using a hospital outside the Bestmed network.
Yes, spinal fusion surgery is covered under Bestmed Beat 4.
Yes, mental health services, including therapy and medication, are covered under Bestmed Beat 4 for individuals with depression.
Bestmed Beat 4 provides comprehensive coverage for chronic conditions, including diabetes, hypertension, asthma, and more. Members with chronic conditions can receive ongoing care and treatment without worrying about reaching annual limits.
Bestmed Beat 4 covers a range of postnatal care services, including prenatal consultations, postnatal consultations, and routine newborn care.
Yes, Bestmed Beat 4 is designed to offer value for money by providing comprehensive coverage for a wide range of medical services, including chronic benefits and oncology services, at a reasonable premium.Β Therefore, by signing up for Beat 4, members can receive quality healthcare and enjoy the benefits of not paying out-of-pocket medical expenses.
Yes, Bestmed Beat 4 covers HIV/AIDS testing and treatment.
Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.
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