Bestmed Beat1: 2027 contributions and benefits

At a glance

Plan type: Hospital plan
Hospitals: Any private hospital
Hospital and specialists: 100% of Scheme tariff
Day-to-day costs: Your own
Chronic conditions: 27 (Chronic Disease List)
Cancer: PMB level of care
Overall annual limit: None
Children you pay for: Up to 3
Children on the plan to age: 24

Plan type: Hospital plan
Hospitals: Any private hospital
Hospital and specialists: 100% of Scheme tariff
Day-to-day costs: Your own
Chronic conditions: 27 (Chronic Disease List)
Cancer: PMB level of care
Children you pay for: Up to 3
Children on the plan to age: 23

Monthly contributions

2027 rates take effect on 1 January 2027. You pay for up to 3 children.

Member	2026	2027	Change
Main member	R2 523	R2 712	+7.5%
Adult dependant	R1 959	R2 106	+7.5%
Child	R1 061	R1 109	+4.5%

Benefits

Bestmed has published its full 2027 rules, but we hold only the main rows so far. A row without a 2027 entry shows the 2026 rule, marked.

Benefits in force for 2026.

In hospital

Hospitals

Any hospital

Hospitals

Any hospital

Bestmed Comparative Guide 2027, p9

Specialists in hospital

100% of Scheme tariff. A specialist who charges more leaves a shortfall.

Bestmed Beat 1 Product brochure 2026, p4

Specialists in hospital

100% of Scheme tariff. A specialist who charges more leaves a shortfall.

Bestmed Comparative Guide 2027, p9

Day procedures

A co-payment of R2 872 when done in an acute hospital instead of a day hospital.

Bestmed Annexure B1 - Benefit Options - Beat Range 2026, p22

Day procedures

A co-payment of R2 987 when done in an acute hospital instead of a day hospital.

Bestmed Comparative Guide 2027, p14

Private ward

Not covered.

Your Guide to Bestmed 2026, p11

Private ward

2027 not in our records yet. 2026: Not covered.

Your Guide to Bestmed 2026, p11 (2026)

Chronic and cancer

Chronic conditions

27 conditions, the Chronic Disease List.

Chronic conditions

27 conditions, the Chronic Disease List.

Bestmed Comparative Guide 2027, p49

Chronic medicine outside the formulary

A co-payment of 30% applies.

Bestmed Beat 1 Product brochure 2026, p6

Chronic medicine outside the formulary

A co-payment of 30% applies.

Bestmed Comparative Guide 2027, p18

Cancer

Cover at the PMB level of care, through ICON.

Bestmed 2026 Comparative Guide, p9

Cancer

Cover at the PMB level of care.

Bestmed Comparative Guide 2027, p13

Dialysis

Through National Renal Care.

Bestmed Managed Care Guide 2026, p16

Dialysis

2027 not in our records yet. 2026: Through National Renal Care.

Bestmed Managed Care Guide 2026, p16 (2026)

Day to day

Maternity

Maternity care programme, paid from the scheme’s risk benefits, not savings.

Bestmed Managed Care Guide 2026, p18-19

Maternity

Maternity care programme, paid from the scheme’s risk benefits, not savings.

Bestmed Comparative Guide 2027, p22

Children on the plan

As dependants up to age 24.

Children on the plan

As dependants up to age 23.

Bestmed Comparative Guide 2027

GP visits

Not covered.

Bestmed Beat 1 Product brochure 2026, p3

GP visits

Not covered.

Bestmed Comparative Guide 2027, p23

Specialist visits

Not covered.

Bestmed Beat 1 Product brochure 2026, p3

Specialist visits

Not covered.

Bestmed Comparative Guide 2027, p23

Prescribed medicine (acute)

Not covered.

Bestmed Beat 1 Product brochure 2026, p6

Prescribed medicine (acute)

Not covered.

Bestmed Comparative Guide 2027, p23

Basic dentistry

Not covered.

Bestmed Beat 1 Product brochure 2026, p3

Basic dentistry

Not covered.

Bestmed Comparative Guide 2027, p23

Eyes (optometry)

Not covered.

Bestmed Beat 1 Product brochure 2026, p3

Eyes (optometry)

Not covered.

Bestmed Comparative Guide 2027, p23

Basic X-rays

Not in our 2026 records.

Basic X-rays

Not covered.

Bestmed Comparative Guide 2027, p23

Blood tests (pathology)

Not covered.

Bestmed Beat 1 Product brochure 2026, p3

Blood tests (pathology)

Not covered.

Bestmed Comparative Guide 2027, p23

Full benefit list

Every benefit we hold for Beat1, in Bestmed’s own wording, from its 2026 documents. Bestmed’s full 2027 list is not in our records yet.

In hospital

Accommodation (hospital stay) and theatre fees

100% Scheme tariff.

Bestmed Beat 1 Product brochure 2026, p3

Biological medicine during hospitalisation

100% Scheme tariff. Limited to R12 144 per family per annum. Subject to pre-authorisation and funding guidelines.

Bestmed Beat 1 Product brochure 2026, p3

Treatment of chemical and substance abuse

Benefits shall be limited to the treatment of PMB conditions and subject to the following: • Pre-authorisation • DSPs • 21 days’ stay for in-hospital management per beneficiary per annum.

Bestmed Beat 1 Product brochure 2026, p4

Surgical procedures and anaesthetics

100% Scheme tariff.

Bestmed Beat 1 Product brochure 2026, p4

Stem cell transplants

100% Scheme tariff (PMBs only).

Bestmed Beat 1 Product brochure 2026, p4

Prosthesis – Internal

Sub-limits per beneficiary per annum: • *Functional R35 613. • Pacemaker (single and dual chamber) R54 390. • Vascular R57 441. • Spinal including artificial disc R39 819. • Drug-eluting stents - subject to Vascular prosthesis limit. • Mesh R13 975. • Gynaecology / urology R11 419. • Lens implants R8 713 a lens per eye.

Bestmed Beat 1 Product brochure 2026, p4

Oncology

100% Scheme tariff, subject to pre-authorisation, designated or preferred service providers, and protocols. Essential ICON protocols apply.

Bestmed Beat 1 Product brochure 2026, p4

Birth (in hospital)

100% Scheme tariff.

Bestmed Beat 1 Product brochure 2026, p5

Planned PMB procedures

PMBs only.

Bestmed Beat 1 Product brochure 2026, p5

Step-down and sub-acute care

100% Scheme tariff.

Bestmed Beat 1 Product brochure 2026, p5

Day procedures

Day procedures performed in a day hospital by a DSP provider will be funded at 100% network or Scheme tariff, subject to pre-authorisation, protocols, funding guidelines and DSPs. A co-payment of R2 872 will be incurred per event if a day procedure is done in an acute hospital that is not a day hospital. If a DSP is used and the DSP does not work in a day hospital, the day procedure co-payment will not apply if done in acute hospital, if it is arranged with the Scheme before

Bestmed Beat 1 Product brochure 2026, p5

HIV/AIDS

100% Scheme tariff. Subject to pre-authorisation and DSPs.

Bestmed Beat 1 Product brochure 2026, p6

Peritoneal dialysis and haemodialysis

100% Scheme tariff. Subject to pre-authorisation and DSPs.

Bestmed Beat 1 Product brochure 2026, p6

Step-down and sub-acute care

NPWT treatment shall be at 100% Scheme tariff, subject to pre-authorisation. General wound care shall be at 100% Scheme tariff and be limited to R4 463 per family per annum.

Bestmed Beat 1 Product brochure 2026, p6

Rehabilitation services after trauma

PMBs only. Subject to pre-authorisation and DSPs.

Bestmed Beat 1 Product brochure 2026, p6

Travel cover

Holiday travel: Limited to 90 days and R5 000 000 per family

Bestmed Beat 1 Product brochure 2026, p5

Fertility treatment

Not covered. Examinations, tests and treatment of impotence and of infertility or artificial insemination or artificial fertilisation

Bestmed Annexure C - General Exclusions 2026, p2

Day to day

Prosthesis – External

Not covered. No benefit. (PMBs only).

Bestmed Beat 1 Product brochure 2026, p4

Orthopaedic and medical appliances

100% Scheme tariff. Limited to R15 690 per family per annum.

Bestmed Beat 1 Product brochure 2026, p4

Dental and oral surgery (in or out of hospital)

PMBs only at DSP day hospitals.

Bestmed Beat 1 Product brochure 2026, p4

CDL and PMB chronic medicine

100% Scheme tariff. Co-payment of 30% for non-formulary medicine.

Bestmed Beat 1 Product brochure 2026, p6

Acute medicine

Not covered. No benefit.

Bestmed Beat 1 Product brochure 2026, p6

Alternative healthcare

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Auxiliary services

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Contraceptives

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Basic dentistry

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Casualty visits

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

GP visits

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Hearing aids

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Psychologist and counselling visits

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Eyes (optometry)

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Over-the-counter medicine

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Blood tests (pathology)

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Physiotherapy and other therapists

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Care after a hospital stay

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

MRI, CT and PET scans

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Specialist visits

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Procedures in the doctor’s rooms

Not covered. ad hoc out-of-hospital services are for the member’s own account

Bestmed Beat 1 Product brochure 2026, p3

Maternity care (out of hospital)

100% Scheme tariff.

Bestmed Beat 1 Product brochure 2026, p5

Screening and prevention

Flu vaccines

All ages. 1 per beneficiary per year. Applicable to all active members and beneficiaries.

Bestmed Beat 1 Product brochure 2026, p8

Baby growth and development assessments

0-2 years. 3 assessments per year. Assessments are done at a Bestmed Network Pharmacy Clinic.

Bestmed Beat 1 Product brochure 2026, p8

Colon cancer screening

40 years and older. Once every 24 months. Faecal occult blood test (FOBT). To be done at a GP or specialist, the consultation shall be paid from the available consultation benefit.

Bestmed Beat 1 Product brochure 2026, p8

PSA screening

Males 45 years and older. Once every 24 months. To be done at urologist or GP. Urologist or GP consultation paid from the available consultation benefit.

Bestmed Beat 1 Product brochure 2026, p8

Prescribed Minimum Benefits

PMB conditions

Benefits relating to conditions that meet the criteria for PMBs will be covered in full when using DSPs

Bestmed Beat 1 Product brochure 2026, p3

Not covered on this option

No benefit for

Chronic medicine (other conditions), other than Prescribed Minimum Benefits.

Bestmed Annexure C - General Exclusions 2026, p3

Conditions

The Chronic Disease List conditions are Prescribed Minimum Benefits on every medical aid. How each one works on a medical aid:

Bestmed’s 2026 documents name no chronic conditions beyond the Chronic Disease List on Beat1.

Questions about Beat1

Answered from Bestmed’s documents.

Who is Beat1 for?

In Bestmed’s own words (Bestmed Beat 1 Product brochure 2027, p2): “You are an individual that is looking for a hospital plan that offers good value for money and extensive hospital cover.”

How much does Beat1 cost in 2027?

From 1 January 2027: R2 712 a month for the main member, R2 106 for an adult dependant and R1 109 for a child. You pay for up to 3 children.

How much is Beat1 going up for 2027?

For the main member, from R2 523 to R2 712 a month, +7.5%.

What is the difference between Beat1 and Beat1 Network?

Beat1 Network uses Bestmed’s hospital network; Beat1 lets you use any hospital. In 2027 the main member pays R2 712 on Beat1 and R2 439 on Beat1 Network.

Does Beat1 pay for GP visits and day-to-day costs?

No. Beat1 is a hospital plan, so day-to-day costs are your own.

How many chronic conditions does Beat1 cover?

27, the conditions on the Chronic Disease List.

Is cancer treatment covered?

Yes, at the PMB level of care.

Until what age can children stay on as dependants?

Up to age 23 in 2027 (24 in 2026).

Will I have a shortfall if my specialist charges more?

Beat1 pays specialists in hospital at 100% of the Scheme tariff. If a specialist charges more than that, the difference is a shortfall. Gap cover is the product that pays shortfalls.

Compare my picks →On this plan? Get help with it →Beat1 Network →All Bestmed plans →Bestmed 2027 price changes →Gap cover →

Factual information from Bestmed Medical Scheme’s published documents. It is not advice. Compiled by Eldon de Waal, CFA, the licensed advisor behind AURA. Catalogue v175, built 2026-10-19.