Please note:
DSP = Designated Service Provider
PMB = Prescribed Minimum Benefits
*For full details refer to the 2021 Bonitas Product Brochure.
In-hospital benefits
| Hospital network | Yes |
|---|---|
| Hospital Cover | Unlimited |
| GP and specialist consultations (Network doctors covered in full at the Bonitas Rate) |
Unlimited at 100% of the Bonitas Rate |
| Blood tests and x-rays | Unlimited at 100% of the Bonitas Rate |
| MRIs and CT scans | R13 710 per family (In and out-of-hospital) (R1 500 co-payment per scan, except for PMB) |
| Internal and external prostheses | R33 220 per family (Internal only) |
| Internal nerve stimulators | N/A |
| Cochlear implants | N/A |
| Mental health hospitalisation | R16 370 per family |
| Sublimit of hospitalisation for mental health consultations per family (In or out-of-hospital) |
R9 890 per family |
| Take-home medicine | R405 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) |
R165 500 per family |
| 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 | PMB only |
| HIV/AIDS (Subject to registration on the HIV/AIDS programme) |
Unlimited, if you register on the HIV/AIDS programme |
| Co-payments for certain procedures (Refer to product brochure for details) |
Various procedure specific co-payments. Co-payment for cataract surgery at non-DSP |
Out-of-hospital benefits
| Day-to-day benefit | *Ranges from R2 750 – R6 730 |
|---|---|
| GP benefit | *Ranges from R1 960 – R5 200 for network GPs GP nomination applies to Primary Select |
| GP and specialist consultations (Network doctors covered in full at the Bonitas Rate) |
Unlimited at 100% of the Bonitas Rate |
| GP consultations | Paid from available GP benefit |
| Specialist consultations | Paid from available day-to-day benefit |
| X-rays and ultrasounds | Paid from available day-to-day benefit |
| Blood tests | Paid from available day-to-day benefit |
| Acute medicine (Formulary and Bonitas Pharmacy Network applies. 20% co-payment for non-network or non-formulary use) |
Paid from available day-to-day benefit |
| Over-the-counter medicine (Formulary and Bonitas Pharmacy Network applies. 20% co-payment for non-network or non-formulary use) |
R515 per beneficiary, R1 510 per family |
| Paramedical/Allied medical professionals (Such as occupational therapists and dieticians) |
Paid from available day-to-day benefit |
| General medical appliances | Paid from available day-to-day benefit |
| Hearing aids | N/A |
| Optometry (Once every 2 years) |
R4 955 per family, every 2 years |
| Refractive surgery | N/A |
| Basic dentistry (Subject to dental management protocols) |
Covered at the Bonitas Dental Tariff, subject to the Bonitas Dental Management Programme |
| Specialised dentistry (Subject to dental management protocols) |
N/A |
| Chronic benefits (Subject to Managed Care Protocols) |
Unlimited for PMB, 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 | N/A |
| Antenatal consultations | 6 |
| 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) |
1 |
| 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) |
1 |
| Paediatric consultations (Infants under the age of 1) |
1 |
Preventative care benefits
| Flu vaccine per beneficiary | 1 |
|---|---|
| HIV test per beneficiary | 1 |
| Full lipogram (Every 5 years, for members aged 20 and over) | 0 |
| 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) |
0 |
Wellness benefits
| Wellness extender
(Benefit includes: GP, biokineticist, dietician or physiotherapy consultation(s), a programme to stop smoking, blood tests or x-rays) |
R1 310 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 |