Hospital Rate of Payment:
Co-payment of R3 619 on all endoscopicinvestigations and specialised diagnosticimaging if done in a private hospital.Any other facility, no co-payment
Upfront Payments to hospitals:
Co-payment of R3 619 on all endoscopic
investigations and specialised diagnostic
imaging if done in a private hospital.
Any other facility, no co-payment
Specialists:
Savings account.FP and Specialist consultations only atBestmed DSPs at network tariffs.
Oncology / Cancer:
payments.Oncology PMBs only at DSPs.
Joint Replacements:
Joint replacement surgery (except forPMBs). PMBs subject to prosthesis limits:• Hip replacement and other majorjoints R31 553• Knee replacement R38 903• Other minor joints R12 101
Medical and Surgical Appliances:
In Hospital Dentistry:
Preventative care benefits.Contraceptive benefit.Wound care benefit.Preventative dentistry.
Take home Medicine:
100% Scheme tariff.Limited to 7 days’ medicine.
Rehabilitation, Hospice and Step-down facilities:
Treatment for Mental Health:
100% Scheme tariff.Limited to 21 days per beneficiary
HIV / AIDS:
100% Scheme tariff. Subject to preauthorisationand DSPs.
International Travel Benefit:
Up to R10 million and a maximum of90 days. Services rendered by BryteInsurance and managed by ER24.
