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

This page has overview information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonStart Plus. 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: Bonstart Plus
Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated
GPs and Specialists:	GPs: 100% scheme rate Specialists: 100% scheme rate	Gap Cover: Can push payout up to 700% scheme rate (Plans coming soon)
Hospital Choice:	Long stay: Network hospital Day procedure: Day network hospital
Penalty for using other hospital:	Use of non-network long stay hospital: R12,680 penalty Use of non-network Day hospital: R12,680 penalty	Gap Cover: Can cover the penalty in full (Plans coming soon)
Co-payments:	R1,240 co-payment per admission, except for motor vehicle accidents, maternity confinements and emergency treatment Laparoscopic Hysterectomy: R3,160 co-payment Arthroscopy (when done as part of a surgical procedures): R3,160 co-payment Specialized radiology: R2,800 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.	Gap Cover: Can cover most co-payments (Plans coming soon)
Specialised Radiology:	MRI and CT Scans: R19,130 per family R2,240 co-payment, unless PMB	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Scopes:	PMBs only	Gap Cover: Can cover most co-payments and increase sublimits (Plans coming soon)
Supplementary Services: (Physio, etc)	PMBs only Physical rehabilitation: R62,620 per family
Transplants:	PMBs only
Dialysis:	PMBs only
Exclusions:	Back and neck surgery Correction of Hallux Valgus Non-cancerous breast conditions Nail disorders Skin disorders, including benign growths and lipomas Knee and shoulder surgery Joint replacement surgery Functional nasal and sinus surgery Varicose vein surgery Reflux and Hernia repair surgery All endoscopies In-hospital dental surgery 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): R20,090 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: Bonstart Plus
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:	Network GPs: Unlimited, with R75 co-payment Non-Network GPs: 2 consults, per family for emergencies Virtual consults: Unlimited
Childcare:	Hearing screening: Newborns, in or out of hospital Congenital hypothyroidism screening: Infants under 1 month old Immunisations: Covered Dentistry: Fissure sealants on permanent teeth for children under 16yrs	Gap Cover: Can pay for child ER visits (Plans coming soon)
Specialists consultations:	GP referred: 2 consult per family, up to R2,480, and R130 co-payment Includes: acute meds, basic radiology, specialised radiology and pathology
Pathology:	GP referred: R3,450 per family Benefit shared with acute medicine, x-rays and blood tests
General radiology:	GP referred: R3,450 per family Benefit shared with acute medicine, x-rays and blood tests
Specialised radiology:	PMBs only	Gap Cover: Can pay co-payments and increase sublimits (Plans coming soon)
Scopes:	PMBs only	Gap Cover: Can pay co-payments and increase sublimits (Plans coming soon)
Supplementary Services: (Physio, etc)	Physiotherapy: 4 consults for sport-related injuries with a R75 co-payment Otherwise, PMBs only
General Appliances:	R6,860 per family
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: Bonstart Plus
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:	GP referred: R3,450 per family, with 20% co-payment Benefit shared with acute medicine, x-rays and blood tests
Over-the-counter:	R180 per event, and R860 per family per year
Birth Control:	R1,270 per family
On Discharge:	R470 per person and max 7 days, 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