2026 Rules Active
2026 Validated
Higher Oncology Threshold and Extended Oncology Benefit
Actuarial Objective
For members with anticipated high oncology spend who need a higher base oncology threshold, Oncology Innovation Benefit and Extended Oncology Benefit but do not require Executive’s unlimited ATB.
Running Actuarial Simulation...
More Plan Options
Save R1271 pm
Bestmed
Pace2
Strategy: Senior Funding Elective Joint Replacement
Upgrade for +R27 pm
Bestmed
Pace 3
Strategy: Funding for High-Cost Biological Medicine
Key Terms for this Strategy
- Medical Savings Account (MSA)
- A fund of R30,111 included in your premium. You use this for day-to-day expenses like GP visits and scripts.
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
People Also Ask
If I get diagnosed with cancer, what happens when my cover goes past R500,000?
Cancer cover is limited to R500,000 over a 12-month cycle at 100% DHR, and after that the plan pays up to 80% of DHR (so you may face a 20% shortfall vs DHR on further approved treatment).
Do I need gap cover because specialists can charge above scheme rates?
In hospital the plan can pay up to 200% of the Discovery Health Rate for certain providers, but many benefits outside hospital are paid around 100% DHR and the plan has specific co-pay triggers, so gap cover is typically recommended.
Could I really have to pay R8,400 upfront just to have scopes done?
Yes—if both a gastroscopy and colonoscopy are done in the same admission outside the Day Surgery Network, the stated upfront payment can be up to R8,400 on this plan.
If I do scopes in a doctor’s rooms, can there still be a co-payment?
Yes—when scopes are performed in-rooms at a non-network provider, the stated co-payment for bi-directional scopes is R3,100.
If I need an MRI that isn’t linked to a hospital admission, do I pay first?
If the scan is not related to an approved hospital admission, the first R4,000 comes from available day-to-day benefits before the rest can be paid from the Hospital Benefit (up to DHR).
How much do I actually pay every month in 2026 as the main member?
From 1 April 2026 the main-member contribution shown for Classic Comprehensive is R10,037 per month.
How much Medical Savings do I get in a year on this plan?
Because the Medical Savings Account is described as 25% of the monthly contribution, the calculated annual savings allocation based on R10,037 is R30,111.
If I use a hospital outside a network, is there an automatic upfront admission penalty?
No specific upfront hospital admission penalty is stated for Classic Comprehensive (the guide describes an upfront amount for non-network planned admissions on Classic Smart instead).
If I need a planned hip or knee replacement, what’s the risk if I go outside the scheme’s network providers?
For planned hip and knee joint replacements outside the network, the plan’s payment is limited (it pays up to 80% DHR, capped at R31,850 per prosthesis per admission), so there can be large shortfalls if providers charge more.
How many antenatal visits and pregnancy scans are actually covered?
The Maternity Benefit states cover for up to 12 antenatal consultations and up to two 2D ultrasound scans.