In-hospital benefits

Hospital network N/A
Hospital Cover Unlimited
GP and specialist consultations

(Network doctors covered in full at the Bonitas Rate)

Unlimited Specialist covered at 150% of the Bonitas rate. GP covered at 100% of the Bonitas Rate

Blood tests and x-rays Unlimited at 100% of the Bonitas Rate
MRIs and CT scans

R33 050 per family (In and out-of-hospital) (R1 500 co-payment per scan, except for PMB)

Internal and external prostheses

R58 110 for internal prosthesis per family. R58 110 for external prosthesis per family

Internal nerve stimulators

R174 600 per family

Cochlear implants

R292 900 per family

Mental health hospitalisation

R48 470 per family

Sublimit of hospitalisation for mental health consultations per family

(In or out-of-hospital)

R16 430 per family
Take-home medicine

R575 per hospital stay

Physical rehabilitation

R52 320 per family

Alternatives to hospital (Hospice, step-down facilities)

R17 450 per family

Terminal care Unlimited for oncology
Cancer treatment

(Uses the Bonitas Oncology Network. 20% co-payment applies for use of a non-network provider)

R618 500 per family. R245 400 of this can be used for specialised drugs (including biological drugs)

Non-cancer specialised drugs

(Including biological drugs)

N/A
Kidney dialysis

(At DSP, 20% co-payment applies at a non-DSP)

Unlimited at a DSP or 20% co-payment applies
Organ transplants Unlimited
HIV/AIDS

(Subject to registration on the HIV/AIDS programme)

Unlimited. You must register on the HIV/AIDS programme
Co-payments for certain procedures (Refer to product brochure for details) Co-payment applies for spinal surgery without DBC intervention. Co-payment applies for non-ICPS hip and knee replacements. Co-payment for cataract surgery at non-DSP

Out-of-hospital benefits

Day-to-day benefit Subject to available savings
GP benefit Paid from savings
GP consultations Paid from available savings
Specialist consultations Paid from available savings
X-rays and ultrasounds R3 280 per beneficiary. R7 270 per family (Combined benefit)
Blood tests R3 280 per beneficiary. R7 270 per family (Combined benefit)
Acute medicine (Formulary and Bonitas Pharmacy Network applies. 20% co-payment for non-network or non-formulary use) Paid from available savings
Over-the-counter medicine (Formulary and Bonitas Pharmacy Network applies. 20% co-payment for non-network or non-formulary use) Paid from available savings
Paramedical/Allied medical professionals (Such as occupational therapists and dieticians) Paid from available savings
General medical appliances Paid from available savings
Hearing aids R17 810 per family, every 5 years (10% co-payment applies)
Optometry (Once every 2 years) R5 845 per family, every 2 years
Refractive surgery N/A
Basic dentistry (Subject to dental management protocols) R4 950 per family, per year. Covered at the Bonitas Dental Tariff
Specialised dentistry (Subject to dental management protocols) R5 960 per family, per year. Covered at the Bonitas Dental Tariff
Chronic benefits (Subject to Managed Care Protocols) 47 chronic conditions. R11 950 per beneficiary. R24 720 per family. Subject to use of DSP

Additional benefits

Contraceptives (Per family) R1 660 at the DSP
International travel You must register for this benefit prior to departure. Up to R10 million cover per family for medical emergencies when you travel outside South Africa

Maternity benefits

 

Amniocentesis 1
Antenatal classes R1 280
Antenatal consultations 12
Postnatal consultations 4 (1 can be used for a consultation with a lactation specialist)
Private ward N/A
Ultrasound scan 2D 2

Child care benefits

Baby advice line For children under 3 years
Congenital hypothyroidism screening Infants under 1 month old
GP consultations (Children between ages 2 and 12)

N/A

Hearing screening Newborns, in or out-of-hospital
Immunisations According to the Expanded Programme on Immunisation in South Africa
Paediatric consultations (Infants between ages 1 and 2)

N/A

Paediatric consultations (Infants under the age of 1)

N/A

Preventative care benefits

 

Flu vaccine per beneficiary 1
HIV test per beneficiary 1
Full lipogram (Every 5 years, for members aged 20 and over) 1
Mammogram (Every 2 years, women over 40) 1
Pap Smears (Every 3 years, women between ages 21-65) 1
Pneumococcal vaccine (Every 5 years, members aged 65 and over) 1
Prostate screening antigen test (Men between ages 45-69) 1
Stool test for colon cancer (Members between ages 50-75) 1
Bone density screening (Women aged 65 and men aged 70 and over) 1

Wellness benefits

 

Wellness extender (Benefit includes: GP, biokineticist, dietician or physiotherapy consultation(s), a programme to stop smoking, blood tests or x-rays) R1 810 per family. Consultations and treatment paid at 100% of the Bonitas Rate
Wellness screening (Blood pressure, glucose, cholesterol, body mass index and waist-to-hip ratio) 1 per beneficiary

Please note:
DSP = Designated Service Provider
PMB = Prescribed Minimum Benefits
*For full details refer to the 2021 Bonitas Product Brochure.