Please note:
DSP = Designated Service Provider
PMB = Prescribed Minimum Benefits
*For full details refer to the 2021 Bonitas Product Brochure.
Service:
+27 13 737 7035
Authorisations :
+27 13 737 7035
Contact US:
+27 13 737 7035
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 |