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Beat 4 2018

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Medical Aid Year: 
2018
Day to day Benefits: 

Savings account available.
Day-to-day benefits are available.

In Hospital Benefits
Hospital Rate of Payment: 
100% of Scheme Rate
Hospitals: 

100% Scheme tariff.

Specialists: 
Savings first.Limited to M = R3 110, M1+ = R5 541(Subject to overall day-to-day limit)
Radiology and pathology: 
100% Scheme tariff.
Dialysis: 
100% Scheme tariff.Subject to pre-authorisation.
Oncology / Cancer: 
PMBs only at DSPs.
Joint Replacements: 
Joint replacement surgery (except forPMBs). PMBs subject to prosthesis limits:• Hip replacement and other major jointsR32 910• Knee replacement R43 721• Minor joints R13 434
Prosthesis: 

100% Scheme tariff.
Limited to R92 629 per family.

Medical and Surgical Appliances: 
100% Scheme tariff.
Take home Medicine: 
100% Scheme tariff.Limited to 7 days’ medicine.
Rehabilitation, Hospice and Step-down facilities: 
Vested savings.
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.
Day-to-day benefits
Specialist consultations: 

100% Scheme tariff.
Limited to R16 172 per family.

Acute medicine: 

Savings first.
Limited to M = R2 748, M1 + = R5 552
(Subject to overall day-to-day limit)

Over-the-counter (OTC) Medicine: 

**Member choice: 1. R650 OTC limit OR
2. Access to full savings for OTC
purchases (after R650 limit) = selfpayment
gap accumulation.
Includes suncreen, vitamins and minerals
with nappi codes on Scheme formulary.
Subject to the available savings.

Optometry benefits: 
Benefits available every 24 months from date ofservice.Network Provider (PPN)• Consultation - 1 per beneficiary.• Frame = R868 covered AND• 100% of cost of standard lenses (single visionOR bifocal OR multifocal) OR• Contact lenses = R1 510OR...
Basic dentistry: 
Preventative benefit or savings account.Limit once savings exceeded.
Orthodontics: 

subject to pre-authorisation.
Limited to M = R5 381, M1+ = R10 808.
(Subject to overall day-to-day limit)

Radiology and Pathology: 
100% Scheme tariff.
Chronic Conditions
Chronic Conditions: 

"Addison's disease, Asthma, Bipolar mood disorder
Bronchiectasis, Cardiomyopathy
Chronic renal disease, Chronic obstructive pulmonary disease (COPD)
Cardiac failure, Coronary artery disease
Crohn's disease, Diabetes insipidus
Diabetes mellitus type ...

Total Contributions
Beat 4
Medical Aid Plan Name Term: 
Any