Bonitas BonComprehensive medical aid plan: 2020

View all plans in this scheme.
Always consult with your broker before making final decisions regarding your healthcare cover.

BonComprehensive
2020 Costs:
Total Cost pm:

Main member:

R7,207

Adult:

R6,797

Child:

R1,467
Savings: R16,308 R15,384 R3,324
Self Payment Gap:
R4,080 R3,380 R1,550
Above Threshold: No limit No limit No limit



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
IN HOSPITAL PROCEDURES:
BonComprehensive
Scheme Benefits: Notes and Links:
non-Network Specialists:
  • The Blue Plan gap cover will increase this to 500% scheme rate
network Specialists:
  • 150% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
non-Network GPs:
  • 100% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
network GPs:
  • 150% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
Hospital Choice:
  • Choose any hospital
Penalty for using other hospital:
  • n/a
Specialised Radiology:
  • R31,960 per family
Supplementary Services: (Physio, etc)
  • Up to 100% scheme rate
  • Physical rehabilitation: R50,600 per family
  • The Blue Plan gap cover will increase this to 500% scheme rate
Transplants:
  • 100% scheme rate
  • Corneal grafts: R32,130
Co-payments:
  • None
Alternatives to hospitals:
  • Alternatives to hospitalisation: R16,880 per family
  • Terminal care: Unlimited, including hospice/private nursing, home oxygen, pain management, psychologists, social workers
Casualty:
  • Accident and trauma related costs covered if authorised within 24hrs
  • Both the Blue Plan and Red Plan gap cover will pay up to R20,000 per person for unpaid casualty costs in event of emergency
Other:
  • Internal Nerve stimulators: R168,900 per family
  • Deep brain stimulation, excluding prosthesis: R238,000
  • Cochlear implants: R283,300 per family
Note:
  • Gap cover is an add-on to your medical aid, not a stand alone product
  • Gap cover has a maximum benefit payout of R157,000 per person per year for all gap benefits (except dread disease and premium waiver benefits which do not count towards the R157,000 limit)
  • Gap only supplements payment for procedures approved or authorised by your medical aid, and does not cover “penalties” (such as if, for example, you choose a non-DSP doctor for your procedure when the plan required a DSP doctor)



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)

All benefits, including gap benefits, are subject to treatments and procedures being authorised by medical scheme.
The gap benefits listed are for AskAdam gaps, unless otherwise stated. Actual benefits depend on gap choice option.

.
.
OUT OF HOSPITAL BENEFITS (non-PMB):
BonComprehensive
Scheme Benefits Notes and Links:
Main Member: Adult: Child:
Self Payment Gap:
R4,080 R3,380 R1,550
General info:
  • Our recommended gap cover does not pay out-of-hospital claims, unless it is for cancer treatment, dialysis, or MRI/CT scans
GP consultations:
  • From day-to-day benefit, unless PMB
Childcare:
  • Hearing screening for newborns, in or out of hospital
  • Congenital hypothyroidism screening for infants under 1 month old
  • Paediatric consult: 3 consults for child under 1yr; 2 consults for child 1-2yr
  • GP consult: 2 consults per child 2-12yrs
  • Vaccines: South African Vaccines program, plus one flu vaccine
  • Vaccines: Covered
Specialists consultations:
  • From day-to-day benefit, unless PMB
Pathology:
  • From day-to-day benefit, unless PMB
General radiology:
  • From day-to-day benefit, unless PMB
Specialised radiology:
  • Bonitas pays up to R31,960 per family
  • Sublimit increased as necessary for authorised out of hospital MRI and CT Scans
Supplementary Services: (Physio, etc)
  • From day-to-day benefit, unless PMB



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MATERNITY BENEFITS:
BonComprehensive
Scheme Benefits Notes and Links:
Hospital stay:
  • 150% scheme rate
  • The Blue Plan gap cover will increase this to 500% scheme rate
Consultations:
    Paid by Bonitas:
  • 12 consults with GP/gynae/midwife
  • 4 consults with midwife after delivery
  • Antenatal classes: R1,220
Scans:
    Bonitas pays for:
  • 2 x 2D scans
  • 1 amniocentesis



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
CANCER (ONCOLOGY):
BonComprehensive
Scheme Benefits Notes and Links:
Overall coverage (in and out of hospital):
  • R618,500 per family, at a preferred provider
  • Specialised drugs: R245,400, as part of above sublimit
  • Brachytherapy: R44,200



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
DENTISTRY:
BonComprehensive
Scheme Benefits Notes and Links:
Standard Dentistry:
  • Standard Dentistry: from day-to-day benefit.
  • Consider getting Primary Health Care (medical insurance) that will cover you for a lot of out of hospital claims, including standard dentistry like scaling, polishing, fillings, extractions, root canals and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Specialised Dentistry:
  • Specialised dentistry: from day-to-day benefit
In-Hospital Dentistry:
  • Covered if clinical criteria are met
Orthodontics:
  • From day-to-day benefit
Maxillo Facial Surgery:
  • Covered if clinical criteria are met



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MEDICATION:
BonComprehensive
Scheme Benefits: Notes and Links:
Chronic:
  • All medical aid plans pay for treatment of the 27 CDL conditions as required by law. This includes medicine as well as GP or specialist consults, tests etc. Find out more
  • An additional 33 non-CDL conditions> are covered on this plan
  • Overall limit: R14,110 per person and R28,100 per family. Once depleted, 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
Acute (presrcibed) medication:
  • From day-to-day benefit
  • Consider getting Primary Health Care (medical insurance) that will cover you for all GP visits, some specialist visits, acute meds, minor out of hospital procedures, some radiology and pathology, dentistry, optometry and more. It's an excellent complement to a hospital plan.
  • R370/main | R245/adult | R110/child
  • Read more here
Over-the-counter:
  • From day-to-day benefit
Birth Control:
  • R1,610 per family, paid by Bonitas
On Discharge:
  • R555 per person per admission
Biological:
  • Bonitas pays R200,100 per family for non-oncology specialised medicine
  • R245,400 of your oncology benefit can be used towards biological drugs



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
OPTOMETRY:
BonComprehensive
Scheme Benefits: Notes and Links:
Optometry:
Limit:R3,170 per person, every 24 months. Paid by scheme.
Consult:from above limit
Frames:from above limit
Single lensesfrom above limit
Bifocals:from above limit
Multifocalsfrom above limit
Contactsfrom above limit
Refractive Surgery:R21,190 per family
Notes:Above benefits from network provider



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
MENTAL HEALTH:
BonComprehensive
Scheme Benefits Notes and Links:
In-hospital:
  • In-hospital: R46,880 per family. PMBs always paid in full at DSP, and include up to 21 days admission
Out-of-hospital:
  • Out-of-hospital: R15,890 per family sublimit. PMBs always paid in full at DSP
  • Educational psychologist for under 21yr olds
Trauma:
  • PMB conditions are covered for in and out of hospital treatment. For a full list see here.
  • Example of PMB condition: Acute stress disorder accompanied by recent significant trauma, including physical or sexual abuse. Treatment includes hospital admission for psychotherapy / counselling up to 3 days, or up to 12 outpatient psychotherapy / counselling contacts



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
OTHER BENEFITS:
BonComprehensive
Scheme Benefits Notes and Links:
General Appliances:
  • General Appliances: from savings
1.1. Hearing Aids:
  • R26,300 per family every 5 years, with a 10% co-payment
1.2. Wheelchairs:
  • See "General Appliances" limit
Dialysis:
  • Unlimited at DSP provider, or 20% co-payment
International Insurance:
  • Cover for medical emergencies when you travel outside South Africa. You must register for this benefit.
Other:



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
WELLNESS/PREVENTATIVE BENEFITS:
BonComprehensive
Scheme Benefits: Notes and Links:
Flu vaccination:
  • Covered
Pneumonia vaccines:
  • Covered, 65yrs+ every 5 yrs
Biometric Screening:
  • Covered
Child Immunisation:
  • Covered
Pap Smear:
  • Covered, every 3 years for women 21yrs-65yrs
Mammogram:
  • 1 mammogram every 2 years, women 40-74yrs
PAS Test:
  • 1 test for men 45-69yrs, who are high risk for prostate cancer
HIV Test:
  • Covered
Other:
  • One stool test for colon cancer, 50yrs-75yrs
  • One lipogram every 5yr, 20yrs+
  • One bone density screening every 5 years for women 65yrs+ and men 70yrs+
  • Wellness Extender: costs R2,540 per family and includes choice from following: GP consult(s), Biokineticist, Dietician, Physiotherapy consult and a smoking cessation program, x-rays as per formulary, blood tests as pre formulary



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)
.
.
PROSTHETICS:
BonComprehensive
Scheme Benefits: Notes and Links:
Overal Limit:
  • Internal: R56,200 per family
  • External: R56,200 per family
Sub-limits:
  • Breast prosthesis: R5,360 per breast, limited to two per year



We’ll check if this is still the best plan for you, and send you a comparison with 3 similar plans. (FREE!)

    Important!
  • Unless specified, assume that all benefits are paid are paid at 100% scheme rate
  • No limits or co-payments can apply to treatment of PMBs, which is always unlimited, although subject to strict protocols and scheme rules.
  • “Unlimited” benefits are still subject to authorisation, protocols and sublimits
  • Assume that all benefits need to be pre-authorised