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

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

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

Bonitas: Standard
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:	Any hospital Day procedure: Day network
Penalty for using other hospital:	Use of non-network Day Hospital: R2,590 penalty
Co-payments:	Specialized radiology: R1,860 co-payment In-hospital-dentistry: 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: R34,020 per family, in and out of hospital R1,860 co-payment, unless PMB PET scan: One scan per family
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): R20,500 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 scheme
Other:	Internal Nerve stimulators: R215,800 per family
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: Standard
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. Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R13,440 Main+1= R20,170 Main+2= R22,410 Main+3= R24,650
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:	From day-to-day benefit Main = R3,370 Main +1 = R5,040 Main +2 = R5,610 Main +3+ = R6,720 Shared with specialist benefit When above limit is reached, additional 2 consults, per family
Childcare:	Hearing screening: Newborns, in or out of hospital Vision screening: 2, for premature newborns up to 6 weeks, in or out of hospital Congenital hypothyroidism screening: Infants under 1 month old Paediatric consult: 2 consults for child under 1yr; 2 consults for child 1-2yr GP consult: 2 consults per child 2-12yrs Immunisations: Covered Dentistry: Fissure sealants on permanent teeth for children under 16yrs
Specialists consultations:	If referred by GP, 1 consult per family, otherwise: M = R2,240 M1 = R3,920 M2+ = R5,040 From day-to-day benefit Shared with: GPs and Specialist benefit
Pathology:	Main = R3,370 Main + 1 = R5,040 Main + 2 = R5,610 Main + 3+ = R6,720 Shared with standard radiology benefit From day-to-day benefit
General radiology:	Main = R3,370 Main + 1 = R5,040 Main + 2 = R5,610 Main + 3+ = R6,720 Shared with pathology benefit From day-to-day benefit
Specialised radiology:	R34,020 per family, in and out of hospital, with a R1,860 co-payment
Scopes:
Supplementary Services: (Physio, etc)	From day-to-day benefit Main = R3,370 Main + 1 = R5,040 Main + 2 = R5,610 Main + 3+ = R6,720
General Appliances:	From day to day benefit Stoma products and CPAP: R8,550 per family Insulin pump or CGM: R89,420 per family, every 5 years for type 1 diabetic beneficiaries younger than 18yrs. Blood Pressure Monitor: R1,200 per family, every 2 years from day-to-day benefit
1.1. Hearing Aids:	R8,650 per device every 3 years Maximum 2 devices per family All tests and consultations from Hearing Loss Management Programme are paid by Bonitas
1.2. Wheelchairs:	See above
PMBs= Prescribed Minimum Benefits (more info) | DSP= Designated Service Provider

Medication Benefit (2025):

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

Bonitas: Standard
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. Extended Fund: Extra funds from the scheme for (mostly) out of hospital claims, over and above any savings account Main= R13,440 Main+1= R20,170 Main+2= R22,410 Main+3= R24,650
Chronic:	27 PMB conditions: Covered. You can see the full PMB list here. An additional 18 non-PMB conditions are covered on this plan Overall limit: R12,530 per person and R25,140 per family. Once depleted, only PMBs will continue to be covered by scheme If you voluntarily use medicine that is not on Bonitas' list ("formulary"), you pay a 30% co-payment
Acute (prescribed) medication:	from day to day benefit Shared with Over The Counter benefit Main = R3,370 Main + 1 = R5,040 Main + 2 = R5,610 Main + 3+ = R6,720
Over-the-counter:	R895 per person and R2,800 per family From day to day benefit and shared with Acute Medicine benefit
Birth Control:	R2,050 per family
On Discharge:	7 day supply, up to R605 per person per admission
Biological:	Cancer: R157,800, form Oncology limit
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