Great Out-of-Hospital Claims Using Beat 1 from Bestmed
February 28, 2017
Beat 1 from BestMed is a hospital plan suited to mid-income earners who need extensive individual hospital cover. This entry level scheme supplies great in-hospital benefits, while also giving pre-authorized out-of-hospital cover. At just under R1300, this is not the cheapest plan around, but you will struggle to find in-hospital benefits which are as comprehensive. Here we will be giving you an overview of the pros and cons of one of South Africa’s best single-person plans.
Beat 1 from Bestmed Contributions
BestMed Beat 1 supplies these standard fixed rates, allowing you to receive care from any medical institution of your choice:
- R1 257 for the Principal Member
- R976 per Adult Dependent
- R529 per Child Dependent
A network option locks you to a preset range of medical care providers but lowers your premiums. Here are the discounted rates:
- R1 131 for the Principal Member
- R879 per Adult Dependent
- R476 per Child Dependent
At a surplus of just R126, it makes a far wiser choice to go for their standard rates instead of limiting your choices. With each Beat 1 plan, a maximum of four child dependents is billed by the scheme. More than four children and they are added to your hospital plan at no charge. So if you are on the standard Beat 1 hospital plan and use a non-network provider, you could be liable for a copayment reaching all the way up to R10,000.
Beat 1 from Bestmed In-Hospital Benefits
While the in-hospital cover supplied is comprehensive, there are certain limitations to keep in mind. The 100% scheme tariff cover may leave you liable for a copayment if your hospital care exceeds the tariff set out for the procedure. Bestmed must review each procedure. The following has coverage at the 100% scheme tariff rate:
- Surgical Procedures
- Organ Transplants
- Prosthesis (with a limit of R61,550 per family)
- Dental Prosthesis
- Diagnostic Imaging
- Orthopedic Appliances
- Maternity Care with Mid-Wife Birthing
- 21 Days of Substance Abuse Treatment
- Mental Health
Out-of-Hospital, Preventative and Chronic Cover
Forty-three chronic conditions have coverage by Beat 1 from BestMed. There is, however, no over-the-counter medicine for non-chronic sufferers. So the preventative benefits from this plan are great. You also get yearly flu vaccines, biometric screening and spinal/back rehabilitation cover. Females receive a bi-annual Pap smear and a steady supply of contraceptives. The maternity support is also excellent. It also even supplies you with a 24-hour support line for the duration of your pregnancy.
What Beat 1 Doesn’t Cover
Beat 1’s cover does not support endovascular and catheter base procedures. Artificial disks, drug-eluding stents nor any form of the external prosthesis has coverage. You don’t get any non-CDL chronic, acute or biological medicine. Most high-priced medicines don’t make the cut.
Beat 1 from Bestmed – A Hospital Plan for You Alone
As a stand-alone hospital plan, Beat 1 is a decent medical scheme. So just don’t forget that you must pay for almost all GP and specialist visits. Both the standard and network options give good in-hospital cover with a few fringe benefits. Also, families and older individuals may find better disease and day to day cover elsewhere. For one person, almost every in-hospital expense is safely provided for.
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All info was correct at time of publishing