• Benefits, Bonitas Plan, in-hospital, out-hospital, Scheme Plans

Bonitas BonComprehensive: in-and-out of hospital benefits (2026)

Contents:

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonComprehensive. Please consult and verify with the scheme or your broker for full benefits, and an explanation of all the "fine print".

Terminology:

  • PMBs: Prescribed Minimum Benefits. You can read more about PMBs, see a list of all PMB conditions or read more what "PMB only" benefit means.
  • DSPs: Designated Service Providers. Where stipulated, you must use specific providers to get full benefit.
  • Co-payment: Paid out of pocket, or out of savings account. Sometimes this is refundable to you if you have a gap product.
  • All schemes have extensive exclusions. We've tried to list the non-common ones here, but please consult your scheme or broker to get the full list.

Monthly Costs (2026)

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bonitas: BonComprehensive (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R12,509
  • R11,796
  • R2,548
Savings:
  • R22,512
  • R21,228
  • R4,584
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5,420
  • R4,490
  • R2,050
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • No limit
  • No limit
  • No limit
Children Rates:
  • Up to 24yrs
  • Only pay for 3 children
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In-hospital Procedures (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bonitas: BonComprehensive
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:
  • GPs: 100% scheme rate
  • Specialists: 150% scheme rate
Gap Cover:
Can push payout up to 700% scheme rate
(Plans coming soon)
Hospital Choice:
  • Long stay: Any hospital
  • Day procedure: Day network
Penalty for using other hospital:
  • Use of non-network Day Hospital: R5,440 penalty
 Gap Cover:
Can cover the penalty in full
(Plans coming soon)
Co-payments:
  • Specialized radiology: R2,800 co-payment
  • Dental admission: R2,600 -R5,200 co-payment
Note:
  • If you use a DSP (designated service provider), you never have to pay a co-payment for protocol treatment of a PMB (Prescribed Minimum Benefit). More info here
  • There might be other co-payments, especially if you don't use a DSP for a PMB or when buying medicine.
 Gap Cover:
Can cover most co-payments
(Plans coming soon)
Specialised Radiology:
  • MRI and CT Scans: R38,470 per family, in and out of hospital
  • R2,800 co-payment, unless PMB
  • PET scans: 2 per family
Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Scopes: Gap Cover:
Can cover most co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • 100% scheme rate
  • Physical rehabilitation: R63,340 per family
Transplants:
  • 100% scheme rate
  • Corneal grafts: R40,220
Dialysis:
  • Covered
Exclusions:
  • NB: See scheme's rules for all exclusions. All schemes have plenty!
 Gap Cover:
Coming soon
Alternatives to hospitals:
  • Alternatives to hospitalisation (hospice, step-down): R20,310 per family
  • Palliative care (oncology): Unlimited, including hospice/private nursing, home oxygen, pain management, psychologists, social workers
  • Home-care: Home based care as alternative to general ward admission
Casualty/ER:
  • ER: 2 visits per family, paid by Bonitas
Gap Cover:
Can cover ER claims
(Plans coming soon)
Other:
  • Internal Nerve stimulators: R211,300 per family
  • Deep brain stimulation, excluding prosthesis: R298,000
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

Out-of-hospital Procedures (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bonitas: BonComprehensive
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
Main Member: Adult: Child:
Savings:
  • R25,632
  • R24,168
  • R5,220
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5,210
  • R4,320
  • R1,970
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • No limit
  • No limit
  • No limit
Other Day-to-Day Funds:
  • Benefit Booster: R2,070 per family and use for out of hospital claims like GP consult(s), OTC medicine, etc
  • Available after completing a wellness screening and mental health assessment.
PMBs out of hospital:
  • All schemes must pay for the diagnosis, treatment and management of all PMB conditions, in or out of hospital. You can see a full list of the conditions here.
  • This can include consults with specialists, blood or other tests, radiology and medicine.
  • PMB benefits must never be paid from your savings account.
  • Schemes usually impose the use of specific providers for treatment of PMBs. Read more about that here.
  • See our Guide to PMBs for more information.
GP consultations:
  • From day-to-day benefit
Childcare:
  • Hearing screening: Newborns, in or out of hospital
  • Congenital hypothyroidism screening: Infants under 1 month old
  • Paediatric consult: 3 consults for child under 1yr; 2 consult for child 1-2yr
  • GP consult: 2 consults per child 2-12yrs
  • Immunisations: Covered
  • Dentistry: Fissure sealants on permanent teeth for children under 16yrs
 Gap Cover:
Can pay for child ER visits
(Plans coming soon)
Specialist consultations:
  • From day-to-day benefit
Pathology:
  • From day-to-day benefit
General radiology:
  • From day-to-day benefit
Specialised radiology:
  • MRI and CT Scans: R38,470 per family, in and out of hospital, with a R2,800 co-payment
 Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Scopes: Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)
Supplementary Services: (Physio, etc)
  • From day-to-day benefit
General Appliances:
  • Insulin pump: R65,000 per family, every 5 years for type 1 diabetic beneficiaries younger than 18yrs. Paid by Bonitas.
  • Continous Glucose Monitor: R28,000 per family, per year for type 1 diabetic beneficiaries younger than 18yrs. Paid by Bonitas.
  • Otherwise, from day to day benefit
1.1. Hearing Aids:
  • R11,340 per device every 3 years, with a 10% co-payment
  • Two devices per person
1.2. Wheelchairs:
  • See above
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

Medication Benefit (2026):

(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)

Bonitas: BonComprehensive
Assume scheme pays all these costs, unless otherwise stated
Main Member: Adult: Child:
Savings:
  • R25,632
  • R24,168
  • R5,220
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R5,210
  • R4,320
  • R1,970
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • No limit
  • No limit
  • No limit
Other Day-to-Day Funds:
  • Benefit Booster: R2,070 per family and use for out of hospital claims like GP consult(s), OTC medicine, etc
  • Available after completing a wellness screening and mental health assessment.
Chronic:
  • An additional 34 non-PMB conditions > are covered on this plan
  • Overall limit: R18,760 per person and R37,360 per family. Once depleted, PMBs will continue to be covered by scheme
  • If you voluntarily use medicine that is not on Bonitas' list ("formulary"), you pay a 30% co-payment
Acute (prescribed) medication:
  • From day-to-day benefit
  • Above threshold limit: R18,560, combined with OTC
Over-the-counter:
  • From day-to-day benefit
Birth Control:
  • R2,050 per family
On Discharge:
  • 7 days supply, R670 per person per admission
Biological:
  • Oncology drugs: R448,200, from oncology limit
  • Non-Cancer: R257,300 per family
PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme. The benefits listed here are an indication only. Please verify all benefits and their conditions with the scheme.

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