Bestmed Medical Scheme Review
Scheme Background and Review:Having been around for 48 years, Bestmed is one of South Africa's top open medical schemes. With over 73 000 principal members, Bestmed provides medical cover to some 150 000+ members and their dependants. Now under self-administration, and with years of experience and expertise, Bestmed can guarantee that members enjoy top-class service, and excellent, industry-competitive benefits. Bestmed recently announced their 2013 premium increase of 8.99% (average), which is amongst the lowest increase announced by the larger medical schemes. The scheme increased its reserves to R777, 413, while growing its membership to 73,715 principal members and retaining a solvency of 30,22% (well above the legal limit of 25%).
Product Review:Bestmed has 3 ranges of benefits, namely Beat, Pulse and Pace. Within each range you can make certain choices to suit your needs more accurately. These benefit ranges can be summarised as follows:
BEATFor the young and healthy, who are looking for good hospital cover only. MONTHLY PREMIUMS: Beat1: R802 Beat2: R944 Beat3: R1 506 ( member only)
PULSEOffers full hospital benefits with day-to-day benefits provided through a network of doctors and medical providers. Premiums are rated according to your income. MONTHLY PREMIUMS: Pulse1: R802* Pulse2: R2 876 ( member only) *Depending on salary, this may differ
PACEFor the settled family with more specific day-to-day needs. This range of options provides good hospital benefits with quite a big savings account for extensive out-of-hospital expenses. MONTHLY PREMIUMS: Pace1: R1 986 Pace2: R2 688 Pace3: R2655* ( member only) Pace4: R3 655 *Depending on salary, this may differ
REALITY REWARDS by SanlamAlongside the Medical Aid options, Bestmed members also have the added benefits of Reality which entitles you to discounts on gym membership, movie tickets, dining etc. MONTHLY PREMIUMS: Reality R35 Reality+: R99 Reality +gym: R169 Reality Health Single: R97.15 Reality Health Family: R115.50 THE ABOVE ARE 2012 RATES
Unique Features:Bestmed has been able to keep it simple in an industry with a lot of complexities by grouping the options in only 3 different “ranges”, which guides a potential member with ease to the right type of plan for him/her. Bestmed claims to be able to pay 99.2% of all claims within 15 days, which would be a good thing to consider when deciding to join a medical scheme as I have seen some schemes taking 2-3 months to settle claims!
Comparison with Other Medical Schemes:Bestmed have been able to keep their co-payments on procedures lower than the average in the industry. These range from R400 for arthroscopies to R3 000 for hip and knee replacements. Discovery’s highest co-payment being R8 600 for reflux surgery and spinal surgery! Bestmed pays oncology (cancer treatment) at 100% of medical scheme rate without limits (subject to pre-authorisation). Many other schemes puts limits on their oncology benefits, including Discovery with a R200 000 limit per year (with 20% co-pay thereafter) on most options, Momentum with R265 000 limit per year (20% co-pay thereafter). Bestmed firmly believes that its members must be proactive with regards to their health and this is why Bestmed has added preventative care benefits to all of its benefit options. Some of the benefits which are not available on all other schemes are as follows:
- pneumonia programme
- contraceptives (R1 200 pfpa)
- preventative dentistry