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

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

January 6, 2025

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

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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)

Bonitas:BonCap B (2026)
	Main member:	Adult member:	Child member:
Total Cost pm:	R2,111	R2,111	R971
Savings:	No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Children Rates:	Up to 24yrs Pay for all children
Income band:	This plan is only available to households with income in R11,931-R19,350pm band. View other income bands

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In-hospital Procedures (2026):

Bonitas: BonCap B
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:	network Doctors: 100% scheme rate non-network Doctors: 70% scheme rate	Gap Cover: Can push payout up to 700% scheme rate (Plans coming soon)
Hospital Choice:	Long procedure: Network hospital Day procedure: Day network hospital
Penalty for using other hospital:	Use of non-network hospital: 30% penalty	Gap Cover: Can cover the penalty in full (Plans coming soon)
Co-payments:	Specialized radiology: R1,230 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: R14,250 per family R1,230 co-payment unless PMB	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Scopes:	PMBs only	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Supplementary Services: (Physio, etc)	PMBs only Physical rehabilitation: R60,900 per family
Transplants:	PMBs only
Dialysis:	Covered
Exclusions:	Back and neck surgery Joint replacement surgery C-sections for non-medical reasons Functional nasal and sinus surgery Varicose vein surgery Hernia repair surgery Laparoscopic surgery All endoscopies Bunion surgery In-hospital dental surgery NB: See scheme's rules for all exclusions. All schemes have plenty!	Gap Cover: Coming soon
Alternatives to hospitals:	Alternatives to hospitalisation: R17,550 per family Terminal care: Unlimited, including hospice/private nursing, home oxygen, pain management, psychologists, social workers Physical rehab, in-hospital: R60,900 per family
Casualty/ER:	ER: 2 visits per family, paid by Bonitas	Gap Cover: Can cover ER claims (Plans coming soon)
Other:	Blood tests: limited to R32,480 per family, unless PMB Blood transfusions: limited to R23,600 per family, unless PMB
PMBs = Prescribed Minimum Benefits (more info) \| DSP = Designated Service Provider

Out-of-hospital Procedures (2026):

Bonitas: BonCap B

Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated

	Main Member:	Adult:	Child:
Savings (per year):	No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:

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.

Network GPs: Unlimited
Non-network GPs: 1 consult per person and 2 consults per family, limited to R400 per visit with a 30% co-payment

Hearing screening: Newborns, in or out of hospital
Vaccinations: Up to age 12
Congenital hypothyroidism screening: Infants under 1 month old
Dentistry: Fissure sealants on permanent teeth for children under 16yrs

Gap Cover:
Can pay for child ER visits
(Plans coming soon)

Network: 3 consults and R4,060 per person and 5 consults, and R6,030 per family
Non-Network: PMBs only
Benefit pays for: acute medicine, blood tests, MRIs and CT scans, x-rays

Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,390
- M1 = R3,990
- M2 = R4,780
- M3 = R5,220
- M4+ = R5,790

Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,390
- M1 = R3,990
- M2 = R4,780
- M3 = R5,220
- M4+ = R5,790

See specialist benefit, above

Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)

PMBs only

Gap Cover:
Can pay co-payments and increase sublimits
(Plans coming soon)

PMBs only

R7,370 per family

See above

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):

Bonitas: BonCap B

Assume scheme pays all these costs, unless otherwise stated

	Main Member:	Adult:	Child:
Savings (per year):	No savings account option on this plan The scheme might still cover some or all day-to-day claims. See below, and see benefits.
Other Day-to-Day Funds:

27 PMB conditions: Covered. You can see the full PMB list here.

If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 30% co-payment

Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,390
- M1 = R3,990
- M2 = R4,780
- M3 = R5,220
- M4+ = R5,790

R120 per event, and R340 per person per year

R1,330 per family

R470 per person and max 7 days, per admission

PMB level of care

PMBs = Prescribed Minimum Benefits (more info) | DSP = Designated Service Provider

More benefits for this plan >>