The Best Medical Aids
The Best Hospital Plans
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 to up to 3 Family Members. The Bestmed Beat 4 Medical Aid Plan starts from R6,059 ZAR.
π International Cover | R500,000 β R3 million |
π€ Main Member Contribution | R6,059 ZAR |
π₯ Adult Dependent Contribution | R5,004 ZAR |
π Child Dependent Contribution | R1,498 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 10, starting from R6,059 and includes an international cover of up to R3 million, 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. According to the Trust Index, Bestmed has a trust rating of 3.5.
π€ Main Member | π₯ +1 Adult Dependent | πΌ +1 Child Dependent |
R6,059 | R5,004 | R1,498 |
π€ Main Member | π₯ +1 Adult Dependent | πΌ +1 Child Dependent |
R848 x 12 Months | R701 x 12 Months | R210 x 12 Months |
Poll: 10 Best Medical Aids in South Africa
Savings Account / Day-to-day Benefits
READ more: 5 Best Comprehensive Medical Aid Plans
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 | Covered up to 100% of the Bestmed tariff. Limited to a 7-day supply. |
πͺ₯ Biological medicine (in-hospital) | Annually limited to R27,746 per family. Subject to pre-approval and financial restrictions. |
π Treatment in Mental Health Clinics | Covered up to 100% of the Bestmed tariff. Limited to 21 days per beneficiary yearly. |
π Chemical and Substance Abuse Treatment | Covered up to 100% of the Bestmed tariff. Limited to 21 days or R37,352 per beneficiary per year. Subject to members using network facilities. |
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. |
π Major medical maxillo-facial surgery (Only specified conditions) | Covered up to 100% of the Bestmed tariff. There is a limit of up to R15,244 per family. |
π In- and Out-of-Hospital Dental and oral surgery | Covered up to 100% of the Bestmed tariff. The scheme risk funds the procedure if beneficiaries are 7 years and younger. There is a limit of R11,673 per family. |
𦡠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 R112,478 per family. |
π¦Ύ 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 β R35,700 Pacemakers (dual chamber) β R65,092 Vascular β R68,250 Spinal, including artificial discs β R38,864 Drug-eluting stents β R21,835 Mesh β R14,420 Gynecology/Urology β R10,575 Lens Implants (per lens, per eye) β R8,239 |
βοΈ External prostheses | There is an annual limit of R27,053 per family. Members must use a DSP. This benefit will cover artificial limbs but is limited to one limb every 60 months. |
β Joint replacement surgery | The following prostheses limits apply to PMBs: Hip replacement and other major joints β R39,962 Knee replacement β R53,090 Other minor joints β R16,313 |
π Orthopedic and Medical Appliances | Covered up to 100% of the Bestmed tariff. |
β¬οΈ Pathology | Covered up to 100% of the Bestmed tariff. |
π Radiology | Covered up to 100% of the Bestmed tariff. |
π MRI, CT scans, and other specialized diagnostics | Covered up to 100% of the Bestmed tariff. |
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©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) | Covered up to 100% of the Bestmed tariff. Subject to pre-approval and other protocols. Covered up to a limit of R10,850 per eye. |
π§ͺ Midwife-assisted birth | Covered up to 100% of the Bestmed tariff. |
π Supplementary Services | 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 | Covered up to 100% of the Bestmed tariff. There is a limit of R99,887 per beneficiary yearly. Subject to benefit availability, pre-authorization, and treatment plan. |
β 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 R2,625 when voluntarily using a non-DSP specialist or hospital. |
π 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. |
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 R14,831 Main Member + Dependents β R29,661 |
β‘οΈ FP and Specialist Consultations | These consultations are first covered using available funds from the medical savings account. The following limits apply and are subject to the overall day-to-day limit: Main Member β R3,777 Main Member + Dependents β R6,728 |
1οΈβ£ 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. Paid initially from the βFP and specialist consultationsβ daily benefit, then Scheme risk. |
2οΈβ£ Basic and Specialized Dentistry | Paid from savings and then from the daily limit. Orthodontics needs pre-approval. The following limits apply to this benefit, subject to the overall day-to-day limit: Main Member β R6,534 Main Member + Dependents β R13,124 |
3οΈβ£ Medical devices/aids, apparatus, appliances (including wheelchairs, crutches, etc.) | Covered from available savings first. Covered up to 100% of the Bestmed tariff. There is a limit of up to R13,321 per family. This benefit includes repairs to artificial limbs. The benefit is subject to the overall day-to-day limit. |
4οΈβ£ Hearing Aids | Subject to pre-approval. There is a limit of up to R12,208 per family every two years. Paid up to 100% of the Bestmed tariff. |
5οΈβ£ Supplementary Services | Covered from available savings first. Limited to the following (subject to overall day-to-day limit): Main Member β R5,768 Main Member + Dependents β R11,714 |
6οΈβ£ Wound Care Benefit (Dressings, negative pressure wound therapy NPWT treatment, and other nursing services Out-of-hospital) | Covered from available savings first. Covered up to 100% of the Bestmed tariff. Limited to R5,768 per family, subject to the overall day-to-day limit. |
7οΈβ£ Optometry | Benefits are available every 24 months from the last date of service. Network Providers (PPN) Consultations β 1 per beneficiary. Frames are covered up to R1,000 and up to 100% of the cost of standard lenses (single, bifocal, or multifocal). Alternatively, beneficiaries are covered up to R1,840 for contact lenses. Non-Network Providers Consultation β R383 fee when using a Non-Network Provider. Frames are covered up to R750 and: R215 for single-vision lenses. R460 for bifocal lenses. R982.5 for multifocal lenses. Alternatively, beneficiaries can opt for contact lenses of up to R1,840. |
8οΈβ£ Basic Radiology and Pathology | Covered from available savings first. Subject to the overall day-to-day limit. The following limits apply: Main Member β R3,776 Main Member + Dependents β R7,690 |
9οΈβ£ Oncology | Oncology program at the full Scheme rate. Subject to pre-approval and DSP. |
π Peritoneal Dialysis and Hemodialysis | Covered up to 100% of the Bestmed tariff. Subject to pre-approval and DSP. |
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 | Covered up to 100% of the Bestmed tariff. Limited to R19,638 per family per year |
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) | Nine conditions are covered. Covered up to 90% of the Bestmed tariff. There is a co-payment of 20% for non-formulary medicine. The following limits will apply: Main Member β R8,748 Main Member + Dependents β R17,496 |
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 R3,337 Main Member + Dependents β R6,742 |
βοΈ OTC Medication | Members can choose an R1,110 limit per family. Alternatively, access is given to a full savings account for OTC medicine after the R1,110 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:
and many more.
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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 | Male Beneficiaries | 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 24 months | 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 R127 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 | π₯ Momentum Extender Plan | π₯ Bonitas BonClassic Plan |
π International Cover | R500,000 β R3 million | Up to R8 million | R10 million |
π€ Main Member Contribution | R6,059 | R5,544 | R6,732 |
π₯ Adult Dependent Contribution | R5,004 | R4,997 | R5,780 |
π Child Dependent Contribution | R1,498 | 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 R11 519 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.
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