This page has information on: Costs, In-hospital, Out of Hospital and Medicine benefits for Bonitas BonStart Plus.
In-hospital Procedures (2024):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
| non-Network Specialists: |
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| network Specialists: |
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| non-Network GPs: |
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| network GPs: |
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| Hospital Choice: |
- Long stay: BonStart Network
- Day procedure: Day network
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| Day Hospitals: |
- Must use Day Hospitals for certain procedures
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| Penalty for using other hospital: |
- Use of non-Network hospital: R12,050
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| Other Co-payments: |
- R1,130 co-payment per admission, except for motor vehicle accidents, maternity confinements and emergency treatment
- Laparoscopic Hysterectomy: R2,890 co-payment
- Arthroscopy (when done as part of a surgical procedures): R2,890 co-payment
- Specialized radiology: R2,130 co-payment
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| Specialised Radiology: |
- MRI and CT Scans: R18,180 per family
- R2,130 co-payment, unless PMB
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| Scopes: |
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| Supplementary Services: (Physio, etc) |
- PMBs only
- Physical rehabilitation: R50,600 per family
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| Transplants: |
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| Dialysis: |
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| Exclusions: |
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
- C-sections for non-medical reasons
- Functional nasal and sinus surgery
- Varicose vein surgery
- Reflux and Hernia repair surgery
- All endoscopies
- In-hospital dental surgery
- Note: All schemes have extensive exclusions. We've tried to list the major ones here, but please consult your scheme or broker to get the full list.
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| Alternatives to hospitals: |
- Alternatives to hospitalisation (hospice, step-down): R19,100 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
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| Casualty: |
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| Other: |
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| 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
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View all the 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.
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| . |
Out-of-hospital Procedures (2024):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, at 100% scheme rate, unless otherwise stated |
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Main Member: |
Adult: |
Child: |
- No savings account option on this plan
- The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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- 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.
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- Wellness Extender: Available after completing a wellness screening or online wellness assessment. Get up to R1,100 per family and use for out of hospital claims like : GP consult(s), OTC medicine, etc
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- Network GPs: Unlimited, with R120 co-payment
- Virtual consults: Unlimited
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- 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
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- GP referred: 1 consult per family, up to R1,250, and R250 co-payment
- Includes: acute meds, basic radiology, specialised radiology and pathology
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- GP referred: R3,160 per family
- Benefit shared with acute medicine, x-rays and blood tests
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- GP referred: R3,160 per family
- Benefit shared with acute medicine, x-rays and blood tests
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| Scopes: |
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- Physiotherapy: 4 consults for sport-related injuries with a R65 co-payment
- Otherwise, PMBs only
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- 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:
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.
|
| . |
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 (2024):
(Other benefits: Costs | Inhospital | Out of hospital | Medication | Maternity | Cancer | Mental Health | Dentistry | Optometry | Other/Extra Benefits | Wellness | Prosthetics)
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Assume scheme pays all these costs, unless otherwise stated |
|
Main Member: |
Adult: |
Child: |
- No savings account option on this plan
- The scheme might still cover some or all day-to-day claims. See below, and see benefits.
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| Chronic: |
- If you voluntarily use medicine that is not on Bonitas's list ("formulary"), you pay a 40% co-payment
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- GP referred: R3,160 per family, with 20% co-payment
- Benefit shared with acute medicine, x-rays and blood tests
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- R165 per event, and R785 per family per year
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- R440 per person and max 7 days, per admission
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- 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:
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.
|
| . |
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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