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

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

In-hospital Procedures (2026):

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

Bonitas: Essential Select
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	Gap Cover: Can push payout up to 700% scheme rate (Plans coming soon)
Hospital Choice:	Long stay: Network hospitals Day procedure: Day network hospital
Penalty for using other hospital:	Use of non-network long stay hospital: 30% penalty Use of non-network Day Hospital: R6,500 penalty	Gap Cover: Can cover the penalty in full (Plans coming soon)
Co-payments:	Specialized radiology: R2,800 co-payment In-hospital-dentistry: R2,600 - R5,200 R2,020 co-payment Colonoscopy Conservative back treatment Cystoscopy Facet joint injections Flexible sigmoidoscopy Functional nasal surgery Gastroscopy Hysteroscopy Myringotomy Tonsillectomy and adenoidectomy Umbilical hernia repair Varicose vein surgery R5,130 co-payment Arthroscopy Diagnostic laparoscopy Laparoscopic hysterectomy (except cancer and PMBs) Percutaneous rhizotomies R9,500 co-payment Laparoscopic pyeloplasty, Laparoscopic radical prostatectomy Nissen fundoplication (reflux surgery) 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.	Gap Cover: Can cover most co-payments (Plans coming soon)
Specialised Radiology:	MRI and CT Scans: R15,960 per family, in and out of hospital R2,800 co-payment, unless PMB	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)	PMBs only Physical rehabilitation: R63,340 per family
Transplants:	PMBs only
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:
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: Essential Select
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: Benefit Booster: R1,160 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:	PMBs only
Childcare:	Hearing screening: Newborns, in or out of hospital Congenital hypothyroidism screening: Infants under 1 month old GP consult: 1 consult per child 2-12yrs Dentistry: Fissure sealants on permanent teeth for children under 16yrs	Gap Cover: Can pay for child ER visits (Plans coming soon)
Specialists consultations:	PMBs only
Pathology:	PMBs only
General radiology:	PMBs only
Specialised radiology:	MRI and CT Scans: R15,960 per family, in and out of hospital, R2,800 co-payment unless PMB	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)	PMBs only
General Appliances:	No benefit
1.1. Hearing Aids:	No benefit
1.2. Wheelchairs:	No benefit
PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider

Medication Benefit (2026):

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

Bonitas: Essential Select
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: Benefit Booster: R1,160 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:	27 PMB conditions: Covered. You can see the full PMB list here. Addtional conditions covered: Depression, R165 per person per month If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 30% co-payment
Acute (prescribed) medication:	No benefit
Over-the-counter:	No benefit
Birth Control:	R1,580 per family, for women up to 50yrs
On Discharge:	7 day supply, up to R470 per person per admission
Biological:	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