At a glance
- Plan type
- Comprehensive plan
- Hospitals
- Any private hospital
- Hospital and specialists
- 100% of Scheme tariff
- Savings account
- R1 409 a month for the main member (14%)
- Chronic conditions
- 47
- Overall annual limit
- None
- Children you pay for
- Up to 3
- Children on the plan to age
- 24
- Plan type
- Comprehensive plan
- Hospitals
- Any private hospital
- Hospital and specialists
- 100% of Scheme tariff
- Savings account
- R1 529 a month for the main member (14%)
- Chronic conditions
- 47
- 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 | R10 064 | R10 919 | +8.5% |
| Adult dependant | R8 101 | R8 790 | +8.5% |
| Child | R1 731 | R1 878 | +8.5% |
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, p25
Specialists in hospital
100% of Scheme tariff. A specialist who charges more leaves a shortfall.
Bestmed Pace3 Product brochure 2026, p3
Specialists in hospital
100% of Scheme tariff. A specialist who charges more leaves a shortfall.
Bestmed Comparative Guide 2027, p25
Day procedures
A co-payment of R2 872 when done in an acute hospital instead of a day hospital.
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p19
Day procedures
A co-payment of R2 987 when done in an acute hospital instead of a day hospital.
Bestmed Comparative Guide 2027, p28
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
47 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Chronic conditions
47 conditions (the 27 on the Chronic Disease List plus others the scheme adds).
Bestmed Comparative Guide 2027, p49
Chronic medicine outside the formulary
A co-payment of 15% applies.
Bestmed Pace3 Product brochure 2026, p8
Chronic medicine outside the formulary
A co-payment of 15% applies.
Bestmed Comparative Guide 2027, p33
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
Medical savings account
14% of your contribution goes into a savings account for day-to-day costs.
Bestmed Annexure B4 - PMSA and Vested MSA 2026, p5
Medical savings account
14% of your contribution goes into a savings account for day-to-day costs.
Bestmed Comparative Guide 2027, p37
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, p36
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
Benefits shall be at 100% of Scheme tariff from the PMSA.
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p34
GP visits
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Specialist visits
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p3
Specialist visits
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Prescribed medicine (acute)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be subject to the overall day-to-day limit and the following maxima per financial year: M = R2 298 and M1+ = R5 169
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p24
Prescribed medicine (acute)
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Basic dentistry
Savings first. 100% Scheme tariff. Limited to M = R9 442, M1+ = R17 603. (Subject to overall day-to-day limit) Orthodontic services subject to pre-authorisation.
Bestmed Pace3 Product brochure 2026, p6
Basic dentistry
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Eyes (optometry)
Benefits available every 24 months from date of service. Network Provider (PPN) • Consultation - One (1) per beneficiary. • Frame = R1 325 covered AND • 100% of cost of standard lenses (single vision OR bifocal OR multifocal) AND Lens enhancement = R750 covered OR • Contact lenses = R2 280 OR Non-network Provider • Consultation - R420 fee at non-network provider • Frame = R994 AND • Single vision lenses = R225 OR • Bifocal lenses = R485 OR • Multifocal lenses at R1 080 (consi
Bestmed Pace3 Product brochure 2026, p7
Eyes (optometry)
2027 not in our records yet. 2026: Benefits available every 24 months from date of service. Network Provider (PPN) • Consultation - One (1) per beneficiary. • Frame = R1 325 covered AND • 100% of cost of standard lenses (single vision OR bifocal OR multifocal) AND Lens enhancement = R750 covered OR • Contact lenses = R2 280 OR Non-network Provider • Consultation - R420 fee at non-network provider • Frame = R994 AND • Single vision lenses = R225 OR • Bifocal lenses = R485 OR • Multifocal lenses at R1 080 (consi
Bestmed Pace3 Product brochure 2026, p7 (2026)
Basic X-rays
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Basic X-rays
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Blood tests (pathology)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Blood tests (pathology)
From the PMSA first (no separate sub-limit).
Bestmed Comparative Guide 2027, p37
Full benefit list
Every benefit we hold for Pace3, 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 Pace3 Product brochure 2026, p3
Take-home medicine
100% Scheme tariff if claimed on the day of discharge, as follows: Limited to a maximum of 7 days treatment if claimed as part of the hospital account, or limited to R600 if claimed from a retail pharmacy. Subject to MRP. No benefit if not claimed within 3 days from the date of discharge.
Bestmed Pace3 Product brochure 2026, p3
Biological medicine during hospitalisation
Limited to the Biological medicine benefit per beneficiary per year as set out on page 8. Subject to pre-authorisation and funding guidelines.
Bestmed Pace3 Product brochure 2026, p3
Treatment in mental health facilities
Approved PMBs at DSPs. Limited to a maximum of 21 days per beneficiary per annum in hospital including inpatient electroconvulsive therapy and inpatient psychotherapy, OR 15 contact sessions for out-patient psychotherapy per beneficiary per annum. Subject to pre-authorisation.
Bestmed Pace3 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 Pace3 Product brochure 2026, p3
Surgical procedures and anaesthetics
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p3
Organ transplants
100% Scheme tariff. (PMBs only)
Bestmed Pace3 Product brochure 2026, p4
Planned PMB procedures
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p4
Internal prostheses
100% Scheme tariff. Limited to R147 394 per family per annum.
Bestmed Pace3 Product brochure 2026, p4
Prosthesis – Internal
Sub-limits per beneficiary per annum: • *Functional R41 358. • Vascular R79 269. • Pacemaker (single and dual chamber) R79 255. • Spinal including artificial disc R73 657. • Drug-eluting stents R24 040. • Mesh R24 040. • Gynaecology / urology R18 030. • Lens implants R15 416 a lens per eye. • Joint replacements: - Hip replacement and other major joints R66 108. - Knee and shoulder replacements R77 001. - Other minor joints R28 471.
Bestmed Pace3 Product brochure 2026, p4
MRI, CT and PET scans
100% Scheme tariff. Limited to a combined in- and out-of-hospital benefit of R43 932 per family per annum. PET scans are limited to one (1) scan per beneficiary per annum. Subject to benefit confirmation and reference number received from the Contact Centre.
Bestmed Pace3 Product brochure 2026, p4
Oncology
100% Scheme tariff, subject to pre-authorisation, designated or preferred service providers and protocols. Essential, Core and Enhanced level ICON protocols apply. Additional access to biological / high cost medicine cover limited to the biological / high cost medicine benefit.
Bestmed Pace3 Product brochure 2026, p4
Peritoneal dialysis and haemodialysis
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Bestmed Pace3 Product brochure 2026, p4
Birth (in hospital)
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p5
Planned PMB procedures
100% Scheme tariff. Subject to pre-authorisation and protocols. Limited to R12 772 per eye.
Bestmed Pace3 Product brochure 2026, p5
Breast surgery for cancer
Treatment of the unaffected (non-cancerous) breast will be limited to PMB provisions and is subject to pre-authorisation and funding guidelines.
Bestmed Pace3 Product brochure 2026, p5
Planned PMB procedures
100% Scheme tariff up to a maximum limit of R100 000 per family per annum. Subject to funding protocols and pre-authorisation.
Bestmed Pace3 Product brochure 2026, p5
HIV/AIDS
100% Scheme tariff. Subject to pre-authorisation and DSPs.
Bestmed Pace3 Product brochure 2026, p5
Step-down and sub-acute care
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p5
Planned PMB procedures
100% Scheme tariff up to a maximum limit of R320 000 per beneficiary per annum. Subject to pre-authorisation and preferred providers or DSPs. Sound processor upgrades every 5 years.
Bestmed Pace3 Product brochure 2026, p5
Advanced illness benefit
100% Scheme tariff, limited to R145 716 per beneficiary per annum. Subject to available benefit, pre-authorisation and treatment plan.
Bestmed Pace3 Product brochure 2026, p5
International medical travel cover
• Holiday travel: Limited to 90 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA • Business travel: Limited to 60 days and R5 000 000 per family, i.e. members and dependants. Limited to R1 000 000 per family for travel to the USA.
Bestmed Pace3 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. 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 the time.
Bestmed Pace3 Product brochure 2026, p5
MRI, CT and PET scans
100% Scheme tariff. Limited to a combined in- and out-of hospital benefit of R43 932 per family per annum. PET scans are limited to one (1) scan per beneficiary per annum. Subject to benefit confirmation and reference number received from the Contact Centre.
Bestmed Pace3 Product brochure 2026, p7
Oncology
100% of Scheme tariff, subject to pre-authorisation, designated or preferred service providers and protocols. Essential, Core and Enhanced level ICON protocols apply. Additional access to biological / high cost medicine cover limited to the biological / high cost medicine limit.
Bestmed Pace3 Product brochure 2026, p7
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
GP visits
Benefits shall be at 100% of Scheme tariff from the PMSA.
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p34
GP visits
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R23 028 and M1+= R47 590
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p34
Specialised dentistry
Benefits shall be at 100% of Scheme tariff from the PMSA.
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p35
Specialised dentistry
Basic and specialised dentistry benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R9 442 and M1+ = R17 603
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p35
Prosthesis – External
100% Scheme tariff. Limited to R34 708 per family per annum. DSPs apply. Includes artificial limbs limited to 1 limb every 60 months. Repair work to artificial limbs will be funded from the out-of-hospital Medical aids, apparatus and appliances benefit.
Bestmed Pace3 Product brochure 2026, p4
Orthopaedic and medical appliances
100% Scheme tariff. Limited to R15 690 per family per annum.
Bestmed Pace3 Product brochure 2026, p4
Blood tests (pathology)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Blood tests (pathology)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Basic X-rays
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Basic X-rays
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R4 508 and M1+ = R8 939
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p41
Physiotherapy and other therapists
Benefits shall be at 100% of Scheme tariff from the PMSA.
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p39
Physiotherapy and other therapists
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R3 396 and M1+ = R7 137
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p39
Medical aids, apparatus and appliances
Savings first. 100% Scheme tariff. Limited to R13 221 per family. Includes repairs to artificial limbs. (Subject to overall day-to-day limit)
Bestmed Pace3 Product brochure 2026, p6
Hearing aids (Subject to pre-authorisation)
100% Scheme tariff. Limit of R33 472 per beneficiary every 24 months. Subject to quotation, motivation and audiogram.
Bestmed Pace3 Product brochure 2026, p6
Optometry benefit
Benefits available every 24 months from date of service. Network Provider (PPN) • Consultation - One (1) per beneficiary. • Frame = R1 325 covered AND • 100% of cost of standard lenses (single vision OR bifocal OR multifocal) AND Lens enhancement = R750 covered OR • Contact lenses = R2 280 OR Non-network Provider • Consultation - R420 fee at non-network provider • Frame = R994 AND • Single vision lenses = R225 OR • Bifocal lenses = R485 OR • Multifocal lenses at R1 080 (consi
Bestmed Pace3 Product brochure 2026, p7
CDL and PMB chronic medicine*
100% Scheme tariff. Co-payment of 15% for non-formulary medicine.
Bestmed Pace3 Product brochure 2026, p8
Prescribed medicine (acute)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be subject to the overall day-to-day limit and the following maxima per financial year: M = R2 298 and M1+ = R5 169
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p24
Prescribed medicine (acute)
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be subject to the overall day-to-day limit and the following maxima per financial year: M = R2 298 and M1+ = R5 169
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p24
Prescribed medicine (acute)
Once all the funds in the PMSA and day-to-day overall limits have been depleted, then these funds may also be used for day-to-day medical expenses
Bestmed Annexure B4 - PMSA and Vested MSA 2026, p5
Female contraceptives
All females of child-bearing age. Quantity and frequency depending on product up to the maximum allowed amount. Oral / injectable / implantable female contraceptives R2 801 per beneficiary per annum OR Intrauterine device (IUD) limited to R4 225 per beneficiary once every 5 years.
Bestmed Pace3 Product brochure 2026, p11
MRI, CT and PET scans
100% Scheme tariff. Limited to a combined in- and out-of-hospital benefit of R43 932 per family per annum. PET scans are limited to one (1) scan per beneficiary per annum. Subject to benefit confirmation and reference number received from the Contact Centre.
Bestmed Pace3 Product brochure 2026, p4
MRI, CT and PET scans
100% Scheme tariff. Limited to a combined in- and out-of hospital benefit of R43 932 per family per annum. PET scans are limited to one (1) scan per beneficiary per annum. Subject to benefit confirmation and reference number received from the Contact Centre.
Bestmed Pace3 Product brochure 2026, p7
MRI, CT and PET scans
PET scans are not subject to that limit — separate, 1 per beneficiary
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p15
Specialist visits
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p3
Maternity care (out of hospital)
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p5
Procedures in the doctor’s rooms
100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p5
Basic dentistry
Savings first. 100% Scheme tariff. Limited to M = R9 442, M1+ = R17 603. (Subject to overall day-to-day limit) Orthodontic services subject to pre-authorisation.
Bestmed Pace3 Product brochure 2026, p6
Auxiliary services
Benefits shall be at 100% of Scheme tariff from the PMSA. Once the funds in the PMSA have been depleted, benefits shall be at 100% of Scheme tariff subject to the overall day-to-day limit and the following maxima per financial year: M = R3 396 and M1+ = R7 137
Bestmed Annexure B2 - Benefit Options - Pace Range 2026, p39
Screening and prevention
Screening and prevention
Benefits payable at 100% of contracted fee. Subject to pre-authorisation, protocols and DSPs.
Bestmed Pace3 Product brochure 2026, p7
Pneumonia vaccines
Children <2 years. High-risk adult group. Children: As per schedule of Department of Health. Adults: Twice in a lifetime with booster above 65 years of age. Adults: The Scheme will identify certain high-risk individuals who will be advised to be immunised.
Bestmed Pace3 Product brochure 2026, p11
Paediatric immunisations
Babies and children. Funding for all paediatric vaccines according to the state-recommended programme.
Bestmed Pace3 Product brochure 2026, p11
Mammogram
Females 40 years and older. Once every 24 months. 100% Scheme tariff.
Bestmed Pace3 Product brochure 2026, p11
HIV rapid test
All ages. Voluntary testing and counselling (VCT) subject to Scheme protocols and funding guidelines.
Bestmed Pace3 Product brochure 2026, p11
Pap smear (procedure and consultation)
Females 18 years and older. Once every 24 months. Can be done at a gynaecologist, GP or pharmacy clinic.
Bestmed Pace3 Product brochure 2026, p12
Glaucoma screening
Ages 50 and above. Once every 12 months. The benefit is subject to service being received from the contracted Optometrist Network only.
Bestmed Pace3 Product brochure 2026, p12
Screening and prevention
12 years and above. Under 12 years. Once a year. Twice a year.
Bestmed Pace3 Product brochure 2026, p13
Intra-oral radiograph
All ages. 2 photos per year.
Bestmed Pace3 Product brochure 2026, p13
Fluoride treatment
All ages. Twice a year (i.e. every 6 months from the date of service).
Bestmed Pace3 Product brochure 2026, p13
Space maintainers
During primary and mixed denture stage. Once per space.
Bestmed Pace3 Product brochure 2026, p13
Not covered on this option
No benefit for
Alternative healthcare, Chronic medicine (other conditions), Casualty visits, Psychologist and counselling visits, Over-the-counter medicine, Care after a hospital stay, 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:
- Addison's Disease
- Asthma
- Bipolar Disorder
- Bronchiectasis
- Dysrhythmia
- Heart Failure
- Cardiomyopathy
- COPD
- Chronic Kidney Disease
- Coronary Artery Disease
- Crohn's Disease
- Type 1 Diabetes
- Type 2 Diabetes
- Epilepsy
- Glaucoma
- Haemophilia
- HIV (Human Immunodeficiency Virus)
- High Cholesterol
- Hypertension
- Hypothyroidism
- Multiple Sclerosis
- Parkinson's Disease
- Rheumatoid Arthritis
- Schizophrenia
- Systemic Lupus Erythematosus (SLE)
- Ulcerative Colitis
Bestmed also names these on Pace3’s 2026 chronic list:
- ADHD
- Allergic Rhinitis
- Ankylosing Spondylitis
- Autism Spectrum Disorder (ASD)
- Chronic Migraine
- Depression
- Eczema / Atopic Dermatitis
- Gastroesophageal Reflux Disease (GERD)
- Obsessive-Compulsive Disorder (OCD)
- Osteoarthritis
- Osteoporosis
- Psoriasis
Others on its list have no page of ours yet.
Questions about Pace3
Answered from Bestmed’s documents.
Who is Pace3 for?
In Bestmed’s own words (Bestmed Pace3 Product brochure 2027, p2): “Those seeking comprehensive in-hospital and out-of-hospital benefits as well as extensive day-to-day benefits to cover out-of-hospital expenses.”
How much does Pace3 cost in 2027?
From 1 January 2027: R10 919 a month for the main member, R8 790 for an adult dependant and R1 878 for a child. You pay for up to 3 children.
How much is Pace3 going up for 2027?
For the main member, from R10 064 to R10 919 a month, +8.5%.
Does Pace3 have a medical savings account?
Yes. 14% of your contribution goes into a savings account, which pays for day-to-day costs such as GP visits and medicine.
How many chronic conditions does Pace3 cover?
47: the 27 on the Chronic Disease List and others the scheme adds.
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?
Pace3 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.
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.