2026 Rules Active
2026 Strategy Validated
Hospital + Savings for Young Singles
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Actuarial Strategy Reference
This strategy is generated based on the 2026 Council for Medical Schemes (CMS) registered rules and actuarial pricing matrices.
VERIFIED: 2025-12-20 | SOURCE: SCHEME_BENEFIT_GUIDE_2026
Similar Situations
Key Terms Explained
Key Terms for this Strategy
- Network Restriction
- You must use hospitals and doctors listed in the scheme's specific network. Voluntary use of non-network providers will result in a heavy co-payment. [Source: Council for Medical Schemes Official Benefit Rules]
- Medical Savings Account (MSA)
- A fund of R5,328 included in your premium. You use this for day-to-day expenses like GP visits and scripts. [Source: Council for Medical Schemes Official Benefit Rules]
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries that are not emergencies. [Source: Council for Medical Schemes Official Benefit Rules]
Common Questions
Do I have to pay for casualty visits upfront? [Network Savings Account Single Starter]
Yes. Beat2 does not provide a specific casualty benefit from the Scheme's risk pool. Emergency room visits where a procedure room is used are paid entirely from your medical savings account at 100% Scheme tariff. You must ensure sufficient savings balance or pay the shortfall out-of-pocket. Strategy reference: ter-2026.
What happens if I need a knee replacement? [Network Savings Account Single Starter]
Joint replacement surgery is excluded except for PMB conditions. If your knee replacement qualifies as a PMB, the prosthesis is subject to the overall family prosthesis limit of R99,764 per year, with a specific sub-limit of R51,686 for knee and shoulder replacements. Hip and other major joints have a sub-limit of R41,918. Strategy reference: ter-2026.
Will my depression medication be covered? [Network Savings Account Single Starter]
Only if depression qualifies as a Prescribed Minimum Benefit (PMB) condition. Beat2 covers CDL and PMB chronic medicines only - the plan lists 27 CDL conditions including Bipolar Disorder and Schizophrenia. Non-CDL chronic conditions receive no benefit. Depression medication would need PMB authorization or be paid from savings. Strategy reference: ter-2026.
Do I pay upfront if I need a gastroscopy? [Network Savings Account Single Starter]
Yes, there is a R2,000 co-payment for gastroscopies and colonoscopies unless the procedure relates to a confirmed PMB condition. Additionally, if the scope is performed in an acute hospital rather than a day hospital, a R2,872 day-procedure co-payment applies. Strategy reference: ter-2026.
What if I use a hospital outside the network? [Network Savings Account Single Starter]
If you have selected the Beat2 Network option and voluntarily choose a non-network hospital, you will incur a R15,025 co-payment. The network option requires you to use specific contracted hospitals - the standard option allows any hospital but costs R309 more per month (R3,084 vs R2,775). Strategy reference: ter-2026.
Am I covered for cancer treatment? [Network Savings Account Single Starter]
Yes. Oncology is covered at 100% Scheme tariff with no annual limit stated, subject to Essential ICON protocols, pre-authorization, and use of designated or preferred service providers. However, biological medicine during hospitalization is limited to R18,215 per family per year. Strategy reference: ter-2026.
Will I need to pay extra for an MRI scan? [Network Savings Account Single Starter]
Yes. MRI scans have a combined in-hospital and out-of-hospital limit of R23,012 per family per year, plus a R2,100 co-payment per scan. The co-payment does not apply if the scan is for a confirmed PMB condition. PET scans are only covered for PMBs. Strategy reference: ter-2026.
Does the plan cover my child's paediatrician visits after birth? [Network Savings Account Single Starter]
Paediatrician visits are not specifically listed as a risk benefit for postnatal care. The maternity benefit covers 6 antenatal consultations and 2 ultrasounds during pregnancy, plus confinement at 100% Scheme tariff. Postnatal paediatrician consults would be paid from your medical savings account. Strategy reference: ter-2026.
Can I see any GP or do I need to use a network doctor? [Network Savings Account Single Starter]
You can see any GP - there is no nominated GP requirement on Beat2. However, GP consultations including emergency unit visits are paid from your savings account, not from the Scheme's risk benefit. Members on the network option must use Scheme-contracted pharmacies and network hospitals. Strategy reference: ter-2026.
What if my savings run out mid-year? [Network Savings Account Single Starter]
Once your medical savings account (R5,328 annual allocation for main member on network option) is depleted, you pay out-of-pocket for day-to-day expenses like GP visits, specialist consultations, acute medication, and basic pathology. Only specific risk benefits (like in-hospital procedures, oncology, dialysis, and PMB conditions) continue without affecting savings. Strategy reference: ter-2026.
Network Savings Account Single Starter strategy verified
Covering 0 family members
2026 rates applied