2017-bonsave-02

Bonitas Bonsave

R2,135.00R5,709.00

This savings option offers sufficient savings to use as you choose for medical expenses and extensive hospital cover.

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Product Description

Please note: This document provides a high-level overview of our plans and benefits. For full benefit information, please refer to the 2017 Product Brochure. Where there is a discrepancy between the content provided in this document, the brochure, the website and the Scheme Rules, the Scheme Rules prevail. The Scheme Rules are available on request. Benefits are subject to approval from the Council for Medical Schemes.

Additional Information

HOSPITAL NETWORK

Yes. Members have access to all private hospitals. A 30% co-payment will apply to admissions at specific hospitals.

MONTHLY CONTRIBUTIONS

M: R2 135
A: R1 654
C: R 640
Your 4th and subsequent children will be covered free of charge

SAVINGS

M: R4 104
A: R3 180
C: R1 236
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GP BENEFIT

Subject to savings
If you use all your savings for the year, your family will still get a maximum of 6 GP consultations (limited to 3 per beneficiary) paid at the Bonitas Rate
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DAY-TO-DAY BENEFIT

N/A
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SELF PAYMENT GAP

N/A
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THRESHOLD LEVEL

N/A
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ABOVE THRESHOLD BENEFIT

N/A
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B

IN-HOSPITAL
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CO-PAYMENTS FOR CERTAIN PROCEDURES

Co-payments will apply to certain procedures in hospital
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GP CONSULTATIONS(IH)

Unlimited, covered at 150% of the Bonitas Rate
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SPECIALIST CONSULTATIONS(IH)

Unlimited, covered at 150% of the Bonitas Rate
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BLOOD TESTS AND X-RAYS

Unlimited, covered at 100% of the Bonitas Rate
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MRI AND CT SCANS

R21 000 per family, in and out of hospital
Pre-authorisation required
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PARAMEDICAL/ALLIED MEDICAL PROFESSIONALS

Unlimited, covered at 100% of the Bonitas Rate
Your therapist must get a referral from the doctor treating you in hospital
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INTERNAL AND EXTERNAL PROSTHESES

Internal and external prostheses
PMB only
Managed Care protocols apply
Pre-authorisation required
You must use a preferred supplier

INTERNAL NERVE STIMULATORS

N/A
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COCHLEAR IMPLANTS

N/A
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MENTAL HEALTH HOSPITALISATION AND CONSULTATIONS

Hospitalisation
R29 000 per family
No cover for physiotherapy for mental health admissions
You must use a Designated Service Provider

Consultations (in and out of hospital)
R14 300 per family
In and out of hospital for consultations (included in the mental health hospitalisation benefit)
No cover for educational psychologists for beneficiaries older than 21 years

TAKE-HOME MEDICINE

R340 per beneficiary, per hospital stay
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PHYSICAL REHABILITATION

R44 650 per family
Pre-authorisation required
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ALTERNATIVES TO HOSPITAL (HOSPICE, STEP-DOWN FACILITIES)

R14 900 per family
Pre-authorisation required
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CANCER TREATMENT

R310 150 per family, at the preferred provider
Pre-authorisation required
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NON-CANCER SPECIALISED DRUGS

N/A
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ORGAN TRANSPLANTS

Unlimited, specialists paid at 150% of the Bonitas Rate
Pre-authorisation required
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KIDNEY DIALYSIS

Unlimited, at the Designated Service Provider
Pre-authorisation required

HIV/AIDS

Unlimited, if you register on the HIV/AIDS programme

C

OUT-OF-HOSPITAL

GP CONSULTATIONS

Paid from available savings
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SPECIALIST CONSULTATIONS

Paid from available savings
You must get a referral from your GP
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BLOOD TESTS AND OTHER LABORATORY TESTS

Paid from available savings
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X-RAYS AND ULTRASOUNDS

Paid from available savings
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MRI AND CT SCANS (SPECIALISED RADIOLOGY)

R21 000 per family, in and out of hospital
Pre-authorisation required
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ACUTE AND OVER-THE-COUNTER MEDICINE

Paid from available savings
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PARAMEDICAL/ALLIED MEDICAL PROFESSIONALS (SUCH AS PHYSIOTHERAPISTS, OCCUPATIONAL THERAPISTS, DIETICIANS AND BIOKINETICISTS)

Paid from available savings
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OPTOMETRY

Paid from available savings
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BASIC DENTISTRY

Covered at the Bonitas Dental Tariff
Managed Care protocols apply
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SPECIALISED DENTISTRY

N/A
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CHRONIC BENEFITS

Cover for 27 PMB chronic conditions at the Designated Service Provider
Applicable formulary applies, 40% co-payment for out of formulary medicine or use of a non-Designated Service Provider
Pre-authorisation required

D

SUPLEMENTARY-BENEFITS

INTERNATIONAL TRAVEL BENEFIT

R5 million per beneficiary per journey for both in and out of hospital treatment (R10 million per family)

MATERNITY CARE PER PREGNANCY

6 antenatal consultations with a gynaecologist, GP or midwife
2 2D ultrasound scans
R1 100 for antenatal classes
1 amniocentesis
4 consultations with a midwife after delivery
A Bonitas baby bag (you must register for this after obtaining pre-authorisation for the delivery)

BABYLINE For children under 2 1⁄2 years

Access to telephone helpline for 24/7 medical advice, including weekends and holidays
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INFANT PAEDIATRIC BENEFIT CHILDREN UNDER 1 YEAR

2 consultations with a paediatrician
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INFANT PAEDIATRIC BENEFIT CHILDREN BETWEEN AGES 1 AND 2

1 consultation with paediatrician
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CHILDHOOD ILLNESS BENEFIT CHILDREN BETWEEN AGES 2 AND 12

1 GP consultation
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D1

PREVENTATIVE-CARE

GENERAL HEALTH

1 HIV test per beneficiary
1 flu vaccine per beneficiary

CARDIAC HEALTH

N/A
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CHILDREN’S HEALTH

N/A
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WOMEN’S HEALTH

1 pap smear every 3 years, for women between ages 21 and 65
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MEN’S HEALTH

N/A
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ELDERLY HEALTH

1 pneumococcal vaccine every 5 years, for members aged 65 and over
1 stool test for colon cancer for members between ages 50 and 75

D2

WELLNESS BENEFITS

WELLNESS SCREENING

1 wellness screening per beneficiary at a participating pharmacy, biokineticist or a Bonitas wellness day
Wellness screening includes the following:
• Blood pressure
• Glucose
• Cholesterol
• Body mass index
• Waist-to-hip ratio

WELLNESS EXTENDER

R1 050 per family
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