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

Bonitas BonEssential Select: in-and-out of hospital benefits (2026)

Contents:

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".

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

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

Bonitas:Essential Select (2027)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,526
  • R1,850
  • R834
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
  • Only pay for 3 children
Bonitas:Essential Select (2026)
Main member: Adult member: Child member:
Total Cost pm:
  • R2,345
  • R1,718
  • R774
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
  • Only pay for 3 children
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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:
    • Specialised 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:
    • 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: R15,960 per family, in-hospital 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)
    • PMB only
    • Physical rehabilitation: R63,340 per family
    Transplants:
    • PMB 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:
    • PMB 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)
    Specialist consultations:
    • PMB only
    Pathology:
    • PMB only
    General radiology:
    • PMB only
    Specialised radiology:
    • MRI and CT Scans: R15,960 per family, in-hospital 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)
    • PMB 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

    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):

    (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:
    • Additional 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:
    • PMB only
    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.

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