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.

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.

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.

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.

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).

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.

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.

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.

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.

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.