Monthly Costs:
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- R1,444
- Only pay for 3 children
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- 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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- Main= R12,780
- Main+1= R19,170
- Main+2= R21,300
- Main+3= R23,430
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- Child rates up to 24yrs
- Only pay for 3 children
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- Exclusions: Note that all schemes have extensive exclusions. We've tried to list the major ones, but you must consult with your scheme to get the full list.
- All treatments and procedures are subject to authorisation and protocols
- All benefits are listed as an indication only. Please verify with your broker and scheme
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♦️View all the other benefits for this plan:♦️
Inhospital |
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
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In-hospital Procedures for 2024:
Assume scheme pays all these costs, unless otherwise stated
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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: Any hospital
- 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: |
- non-Network Day Hospital: R2,590 co-payment
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Other Co-payments: |
- Specialized radiology: R1,560 co-payment
- In-hospital-dentistry: R2,500- R5,000
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Specialised Radiology: |
- MRI and CT Scans: R32,340 per family, in and out of hospital
- R1,770 co-payment, unless PMB
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Supplementary Services: (Physio, etc) |
- 100% scheme rate
- Physical rehabilitation: R61,480 per family
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Transplants: |
- 100% scheme rate
- Corneal grafts: R39,040
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Dialysis: |
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Exclusions: |
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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
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Casualty: |
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Other: |
- Insulin pump: R85,000 pe family, every 5 years
- Internal Nerve stimulators: R205,100 per family
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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:♦️
Inhospital |
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
|
. |
Out-of-hospital Procedures for 2024:
Assume scheme pays all these costs, 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.
|
- Main= R12,780
- Main+1= R19,170
- Main+2= R21,300
- Main+3= R23,430
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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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- This plan has an "extra" fund, so some out of hospital costs are paid from this, from sub-limits per benefit (see below)
- Remember, out of hospital costs authorised as part of PMB treatment (eg. cancer, asthma or stroke) are always paid by the scheme, even on this plan.
- Wellness Extender: Available after completing a wellness screening or online wellness assessment. Get
- Wellness Extender: Available after completing a wellness screening or online wellness assessment. Get up to R5,000 per family and use for out of hospital claims like : GP consult(s), OTC medicine, etc
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- Contracted GPs: see below. Some of the funds may be used for non-Contracted GPs:
- M = R3,200
- M1 = R4,790
- M2 = R5,330
- M3+ = R6,390
- From day-to-day benefit
- Shared with specialist benefit
- When above limit is reached, additional 2 consults, per family
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- Hearing screening: Newborns, in or out of hospital
- Congenital hypothyroidism screening: Infants under 1 month old
- Paediatric consult: 2 consults for child under 1yr; 1 consult for child 1-2yr
- GP consult: 1 consult per child 2-12yrs
- Immunisations: Covered
- Dentistry: Fissure sealants on permanent teeth for children under 16yrs
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- If referred by GP, 2 consults per family, otherwise:
- M = R3,200
- M1 = R4,790
- M2 = R5,330
- M3+ = R6,390
- From day-to-day benefit
- Shared with GPbenefit
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- Shared with standard radiology and pathology:
- M = R3,200
- M1 = R4,790
- M2 = R5,330
- M3+ = R6,390
- From day-to-day benefit
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- Shared with standard radiology and pathology:
- M = R3,200
- M1 = R4,790
- M2 = R5,330
- M3+ = R6,390
- From day-to-day benefit
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- R32,340 per family, in and out of hospital, with a R1,770 co-payment
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- M= R3,200
- M1= R4,790
- M2= R5,330
- M3+= R6,390
- From day-to-day benefit
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- From day to day benefit
- Stoma products: R8,130
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- From R8,650 per device every 3 years
- 2 devices per family
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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:♦️
Inhospital |
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
|
. |
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 for 2024:
Assume scheme pays all these costs, 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.
|
- Main= R12,780
- Main+1= R19,170
- Main+2= R21,300
- Main+3= R23,430
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Chronic: |
- An additional 18 non-PMB conditions are covered on this plan
- Overall limit: R11,910 per person and R23,900 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 40% co-payment
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- From day-to-day benefit
- M= R3,200
- M1= R4,790
- M2= R5,330
- M3+= R6,390
- Shared with Acute and over-the-counter benefit
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- From day-to-day benefit
- M= R3,200
- M1= R4,790
- M2= R5,330
- M3+= R6,390
- Shared with Acute and over-the-counter benefit
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- R575 per person 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:♦️
Inhospital |
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
|
. |
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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