Are you prepared to use designated hospitals?:
Hospital Rate of Payment:
Unlimited at 100% of Bestmed Tariff (BT)
Upfront Payments to hospitals:
If you use a hospital outside of the Beat Hospital Network, there will be an upfront payment of R11 874
Casualty / Emergency Visits:
Specialists:
100% of BT. DSP specialist network applicable
Other healthcare professionals eg. Physio, Occupational, Dietician:
100% of BT. DSP specialist network applicable
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy):
You pay the first R3 800 of the hospital account if done in a private hospital. Any other facility, no co-payment
MRI and CT scans:
100% of BT. You pay the first R3 800 of the hospital account if done in a private hospital. Any other facility, no co-payment
Neck and Back Operations:
Subject to the outcome of referral, assessment and rehabilitation treatment at a Bestmed Document Based Care (DBC) back and neck treatment programme
Joint Replacements:
PMBs only at DSPs and subject to prosthesis limits
Medical and Surgical Appliances:
In hospital; 100% of BT. Out of hospital; no benefit
In Hospital Dentistry:
PMBs only at DSP day hospitals
Take home Medicine:
100% of BT. Limited to 7 days supply
Rehabilitation, Hospice and Step-down facilities:
No benefit for rehabilitation after trauma. Chemical and substance abuse are subject to network facilities and limited to 21 days or R32 299 per beneficiary
Treatment for Mental Health:
100% of BT. Limited to 21 days per beneficiary
International Travel Benefit:
Up to R10 million and a maximum of 90 days. Services rendered by Bryte Insurance and managed by ER24
