This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonCap D.
In-hospital Procedures (2025):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
| non-Network Specialists: |
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| network Specialists: |
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| non-Network GPs: |
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| network GPs: |
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| Hospital Choice: |
- Long stay: BonCap Network hospital
- Day procedure: Day network
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| Day Hospitals: |
- Must use Day Hospitals for certain procedures
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| Penalty for using other hospital: |
- Use of non-Network hospital: 30% penalty
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| Other Co-payments: |
- Specialized radiology: R1,170
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| Specialised Radiology: |
- MRI and CT Scans: R14,250 per family
- R1,170 co-payment unless PMB
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| Scopes: |
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| Supplementary Services: (Physio, etc) |
- PMBs only
- Physical rehabilitation: R60,900 per family
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| Transplants: |
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| Dialysis: |
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| Exclusions: |
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
- Note: All schemes have extensive exclusions. We've tried to list the major ones here, but please consult your scheme or broker to get the full list.
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| 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
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| Casualty: |
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| Other: |
- Blood tests: R31,230 per family, unless PMB
- Blood transfusions: R22,690 per family, unless PMB
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| Note: |
- 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 Provders. Where stipulated, you must use specific 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
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View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Bonitas plans, with costs and brief summary.
Find all other open medical aid plans here.
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Out-of-hospital Procedures (2025):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
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Main Member: |
Adult: |
Child: |
- No savings account option on this plan
- The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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- All medical aids 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
- The benefit is paid by the scheme, and not out of your savings account
- If you have no day-to-day funds, you still have cover for PMBs
- 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.
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- This plan has an "extra" fund, so some out of hospital costs are paid from this, from sub-limits per benefit (see below)
- Remember, out of hospital costs authorised as part of PMB treatment (eg. cancer, asthma or stroke) are always paid by the scheme, even on this plan.
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- Network GPs: Unlimited consults
- Non-network GPs: 1 consult per person and 2 consults per family, limited to R400 per visit with a 30% co-payment
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- 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
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- Network: 3 consults, R3,900 per person and 5 consults, R5,800 per family
- Non-Network: PMBs only
- Benefit pays for: acute medicine, blood tests, MRIs and CT scans, x-rays
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- Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,300
- M1 = R3,840
- M2 = R4,600
- M3 = R5,020
- M4+ = R5,570
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- Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,300
- M1 = R3,840
- M2 = R4,600
- M3 = R5,020
- M4+ = R5,570
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- See specialist benefit, above
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| Scopes: |
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- PMBs: Prescribed Minimum Benefits. To read more about PMBs click here
- DSPs: Designated Service Provders. Where stipulated, you must use specific 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
|
View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Bonitas plans, with costs and brief summary.
Find all other open medical aid plans here.
|
| . |
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 (2025):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, unless otherwise stated |
|
Main Member: |
Adult: |
Child: |
- No savings account option on this plan
- The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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| Chronic: |
- If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 40% co-payment
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- Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
- M = R2,300
- M1 = R3,840
- M2 = R4,600
- M3 = R5,020
- M4+ = R5,570
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- R115 per event, and R330 per person per year
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- R470 per person and max 7 days, per admission
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- Schemes have very strict rules about where you can get your medicine to get full benefit. We do not list the requirements here, so confirm with your scheme before you collect your medicine.
- Formulary: A pre-defined list of approved medicines. Each plan has a different list, and might not pay for non-listed medicine. Confirm with your scheme whether your required medicine is covered by them.
- PMBs: Prescribed Minimum Benfits. To read more about PMBs click here
- DSPs: Designated Service Provders. Where stipulated, you must use specific 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
|
View all the other benefits for this plan:
In-hospital |
Out-of-hospital |
Medication |
Maternity
Cancer |
Mental Health |
Dentistry |
Optometry
Other/Extra Benefits |
Wellness |
Prosthetics
You can also:
Compare any two plans, side by side |
View all the Bonitas plans, with costs and brief summary.
Find all other open medical aid plans here.
|
| . |
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.
|
