Bonitas BonComplete:
in-and-out of hospital benefits (2025)

What's on this page:

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonComplete. 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 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
  • 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 (2025)

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

Bonitas: BonComplete (2025 prices)
Main member: Adult member: Child member:
Total Cost pm:
  • R6,040
  • R4,838
  • R1,639
  • Only pay for 3 children
Savings:
  • R10,848
  • R8,688
  • R2,940
Self Payment Gap:
(What you need to pay out of pocket before you can access the "Above Threshold" benefit)
  • R2,260
  • R1,910
  • R495
"Above Threshold" benefit (ATB):
Additional cover the scheme makes available to you, once you've paid the self payment gap.
  • 6,010
  • 3,520
  • 1,540
Children Rates:
  • Up to 24yrs
  • Only pay for 3 children

In-hospital Procedures (2025):

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

Bonitas: BonComplete
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:
  • GPs: 100% scheme rate
  • network Specialists: paid in full
  • non-network Specialists: 100% scheme rate
Hospital Choice:
  • Network hospital
  • Day procedure: Day network hospital
Penalty for using other hospital:
  • Use of non-network Hospital: 30% penalty
  • Use of non-network Day Hospital: R2,720 penalty
Co-payments:
  • Specialized radiology: R2,800 co-payment
  • Dental admission: R2,500 -R5,000 co-payment
Note:
  • A co-payment is a fee your medical aid can insist you pay, regardless of how much the doctor/charges. It's not the same as an "excess" payment (which is when a doctor charges more than the medical aid rate).
  • 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 if you don't use a DSP, especially if you are being treated for a PMB or when buying medicine.
Specialised Radiology:
  • MRI and CT Scans: R30,430 per family, in and out of hospital
  • R2,800 co-payment, unless PMB
  • PET scans: PMBs only
Scopes:
Supplementary Services: (Physio, etc)
  • 100% scheme rate
  • Physical rehabilitation: R64,680 per family
Transplants:
  • 100% scheme rate
  • Corneal grafts: : R41,070
Dialysis:
  • Covered
Exclusions: .
  • NB: See scheme's rules for all exclusions. All schemes have plenty!
Alternatives to hospitals:
  • Alternatives to hospitalisation (hospice, step-down): R21,570 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
Other:
    PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider

    Out-of-hospital Procedures (2025):

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

    Bonitas: BonComplete
    Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
    Main Member: Adult: Child:
    Savings:
    • R10,848
    • R8,688
    • R2,940
    Self Payment Gap:
    (What you need to pay out of pocket before you can access the "Above Threshold" benefit)
    • R2,260
    • R1,910
    • R495
    "Above Threshold" benefit (ATB):
    Additional cover the scheme makes available to you, once you've paid the self payment gap.
    • 6,010
    • 3,520
    • 1,540
    PMBs out of hospital:
    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: 2 consults for child under 1yr; 1 consult for child 1-2yr
    • GP consult: 1 consult per child 2-12yrs
    • Immunisations: Covered
    • Dentistry: Fissure sealants on permanent teeth for children under 16yrs
    Specialists 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: R30,430 per family, in and out of hospital, with a R2,800 co-payment
    Scopes:
    Supplementary Services: (Physio, etc)
    • From day-to-day benefit
    General Appliances:
    • From day-to-day benefit
    1.1. Hearing Aids:
    • R9,700 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 (2025):

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

    Bonitas: BonComplete
    Assume scheme pays all these costs, unless otherwise stated
    Main Member: Adult: Child:
    Savings:
    • R10,848
    • R8,688
    • R2,940
    Self Payment Gap:
    (What you need to pay out of pocket before you can access the "Above Threshold" benefit)
    • R2,260
    • R1,910
    • R495
    "Above Threshold" benefit (ATB):
    Additional cover the scheme makes available to you, once you've paid the self payment gap.
    • 6,010
    • 3,520
    • 1,540
    Chronic:
    • If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 40% co-payment
    • Additional 4 conditions covered for children under 21yrs
    Acute (prescribed) medication:
    • From day-to-day benefit
    Over-the-counter:
    • From day-to-day benefit
    Birth Control:
    • R2,050 per family
    On Discharge:
    • R635 per person per admission
    Biological:
    • Cancer drugs: Subject to protocols
    • Non-Cancer: PMBs only
    View 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.
    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.


    What does a “PMBs only” restriction mean?
    In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

    What does “From Risk” mean?
    The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

    What is a DSP?
    A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover. 

    Coming Soon