Medical Savings 101

Bestmed Medical Scheme, like some other medical schemes, offer personal medical savings accounts (PMSAs) on certain benefit options. Below are some FAQs from our members to help you answer some of your client’s burning questions.

  1. What is a personal medical savings account?

A PMSA, is a benefit account established in the name of the relevant member. The savings amount available for use for healthcare services and/or products from the PMSA is calculated using a fixed percentage of a member’s total contribution during the financial year. The amount may not exceed 25% of the member’s total gross contribution.

  1. How is the PMSA calculated?

The PMSA is calculated using a fixed percentage of the total contribution.

  1. When do these funds become available?

On 1 January every year (beginning of the financial year).

  1. Do all Bestmed plan options have a PMSA?

No, not all plan options have a PMSA. The Pulse and Beat1 options do not include a PMSA.

  1. What happens when my PMSA runs out?

On Beat4, Pace1, Pace2 and Pace3 your day-to-day benefits will become available. On Beat2 and Beat3, members pay out of pocket after their savings have been depleted.

  1. What is paid for from a PMSA?

Medical expenses for out-of-hospital services are paid from savings if a PMSA is included on your chosen option.

On Bestmed’s Beat4, Pace1, Pace2 and Pace3 options, day-to-day benefits become available once the PMSA is depleted.

Prescribed minimum benefits (PMBs) and co-payments are not funded from the PMSA, nor will available funds be used to offset contributions, provided that the Scheme may use funds in the PMSA to offset debt that the member owes the Scheme, following the member’s termination of their Scheme membership.

  1. Do members lose their personal medical savings if there is an amount that is not used?

Any remaining personal medical savings amount is the property of the member. If a member or their dependants do not use the funds in their PMSA by the end of the financial year, the available funds are transferred to the principal member’s vested savings account, depending on their benefit option.

  1. What are vested savings?

Vested savings are accumulated savings from previous years.

  1. What is paid for from vested savings?

Beneficiaries may request payment of services such as co-payments to be paid from their vested savings, depending on their benefit option.

Beneficiaries may also apply to the Scheme to use their vested savings to pay for additional benefits, such as tinted glasses and certain excluded medicine items. However, costs relating to PMB services, or the self-payment gap, cannot be paid from vested savings.

Some claims are, however, automatically paid for from vested savings. For example, rehabilitation services after trauma are paid for automatically from vested savings on Bestmed’s Beat4 and Pace1 options.

  1. Do I lose the money if I don’t use it?

No, you don’t lose it. It becomes a part of the following year’s savings or will be added to your vested savings, depending on your benefit option.

 Do PMSA and vested savings accounts earn interest?

Yes, members (active or resigned) with positive balances earn interest on the net positive balance of the annual personal medical savings and vested savings accounts.

  1. What happens if a member terminates their scheme membership?

The funds are transferred into the new scheme’s PMSA if a member joins another scheme with a PMSA option. If a member resigns from Bestmed and decides not to join another scheme, the member will receive the balance of funds, including interest earned.

  1. How do I access vested savings?

Members can give permission to pay for claims from the vested savings account. Some claims are automatically paid from vested savings.

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