Bonitas Boncap D:
in-and-out of hospital benefits (2024)

This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonCap D.

We also have information on: Dentistry, Optometry, Wellness and Preventative, Other, Maternity, Cancer, Mental Health and Prosthetics benefits.

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Monthly Costs:

BonCap D 2024 prices
Main member: Adult member: Child member:
Total Cost pm:
  • R3,453
  • R3,453
  • R1,310
  • Pay for all children
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.
Children Rates:
  • Child rates up to 24yrs
  • Pay for all children
Income band:
Note:
  • Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
  • All treatments and procedures are subject to authorisation and protocols
  • All benefits are listed as an indication only. Please verify with your broker and scheme
♦️View all the other benefits for this plan:♦️
Inhospital | 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
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In-hospital Procedures for 2024:

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

Bonitas: BonCap D
Assume scheme pays all these costs, unless otherwise stated
non-Network Specialists:
  • 70% scheme rate
network Specialists:
  • 100% scheme rate
non-Network GPs:
  • 70% scheme rate
network GPs:
  • 100% scheme rate
Hospital Choice:
  • Long stay: BonCap Network hospital
  • Day procedure: Day network
Day Hospitals:
  • Must use Day Hospitals for certain procedures
Penalty for using other hospital:
  • non-Network hospital: 30% co-payment
Other Co-payments:
  • Specialized radiology: R1,170
Specialised Radiology:
  • MRI and CT Scans: R13,550 per family
  • R1,170 co-payment unless PMB
Supplementary Services: (Physio, etc)
  • PMBs only
  • Physical rehabilitation: R57,890 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
Alternatives to hospitals:
  • Alternatives to hospitalisation: R16,680 per family
  • Terminal care: Unlimited, including hospice/private nursing, home oxygen, pain management, psychologists, social workers
  • Physical rehab, in-hospital: R57,890 per family
Casualty:
  • ER: 2 visits per family
Other:
  • Blood tests: R29,690 per family, unless PMB
  • Blood transfusions: R21,570 per family, unless PMB
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
♦️View all the other benefits for this plan:♦️
Inhospital | 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
.
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.

Out-of-hospital Procedures for 2024:

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

Bonitas: BonCap D
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
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.
PMBs out of hospital:
  • 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.
General info:
  • 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.
GP consultations:
  • 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
Childcare:
  • Hearing screening: Newborns, in or out of hospital
  • Congenital hypothyroidism screening: Infants under 1 month old
  • Dentistry: Fissure sealants on permanent teeth for children under 16yrs
Specialists consultations:
  • Network: 3 consults , R3,710 per person and 5 consults, R5,510 per family
  • Non-Network: PMBs only
  • Benefit pays for: acute medicine, blood tests, MRIs and CT scans, x-rays
Pathology:
  • Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
    • M = R2,190
    • M1 = R3,650
    • M2 = R4,370
    • M3 = R4,770
    • M4+ = R5,290
General radiology:
  • Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
    • M = R2,190
    • M1 = R3,650
    • M2 = R4,370
    • M3 = R4,770
    • M4+ = R5,290
Specialised radiology:
  • See specialist benefit, above
Supplementary Services: (Physio, etc)
  • PMBs only
General Appliances:
  • R6,740 per family
1.1. Hearing Aids:
  • See above
1.2. Wheelchairs:
  • See above
Note:
  • 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:♦️
Inhospital | 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
.

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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Medication Benefit for 2024:

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

Bonitas: BonCap D
Assume scheme pays all these costs, unless otherwise stated
Summary of day-to-day benefits:
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.
Chronic:
  • If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 40% co-payment
Acute (presrcibed) medication:
  • Bonitas pays this benefit, which is shared with acute medicine, x-rays and blood tests, up to:
    • M = R2,190
    • M1 = R3,650
    • M2 = R4,370
    • M3 = R4,770
    • M4+ = R5,290
Over-the-counter:
  • R110 per event, and R315 per person per year
Birth Control:
  • R1,260 per family
On Discharge:
  • R445 per person and max 7 days, per admission
Biological:
  • PMBs only level of care
Note:
  • 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:♦️
Inhospital | 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
.

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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