Unlimited, at applicable Hospital Network. R1 590 co-payment per admission, except for PMB emergencies
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
Blood tests limited to R27 560 per family unless PMB. X-rays unlimited, 100% of the Bonitas Rate
MRIs and CT scans
R12 570 per family (R2 500 co-payment per scan, except PMB)
Internal and external prostheses
PMB only
Internal nerve stimulators
N/A
Cochlear implants
N/A
Mental health hospitalisation
PMB only, subject to use of DSP
Sublimit of hospitalisation for mental health consultations per family (In or out-of-hospital)
N/A
Take-home medicine
Limited to a 7-day supply up to R415 per hospital stay
Physical rehabilitation
R53 740 per family
Alternatives to hospital (Hospice, step-down facilities)
R15 470 per family
Terminal care
Unlimited for oncology
Cancer treatment
PMB only, at a DSP or a 30% co-payment applies
Non-cancer specialised drugs
(Including biological drugs)
PMB only
Kidney dialysis
PMB only, at a DSP or a 30% co-payment applies
Organ transplants
PMB only, at a DSP or a 30% co-payment applies
HIV/AIDS
Unlimited, if you register on the HIV/AIDS programme
Co-payments for certain procedures (Refer to product brochure for details)
Yes
Refractive surgery
N/A
Out-of-hospital benefit
Overall day-to-day limit
N/A
GP consultations
Unlimited Network GP consultations, R115 co-payment per visit. Pre-authorisation required from 6th visit.Unlimited Virtual Care GP and Nurse consultations
Specialist consultations
Limited to 1 visit per family up to R1 170. R235 co-payment per visit. Including all acute medicine, basic radiology, specialised radiology and pathology prescribed by the specialist
X-rays and ultrasounds
Limited to R1 590 per family (Combined benefit with blood tests and acute medicine)
Blood tests
Limited to R1 590 per family (Combined benefit with X-rays and acute medicine)
Acute medicine
A 20% co-payment will apply per script. Avoid a 40% co-payment by using a Bonitas Pharmacy Network. Subject to medicine formulary use
Over-the-counter medicine
Limited to R100 per event, R490 per family per year. Subject to the medicine formulary, 40% co-payment for non-DSP use
Paramedical/Allied medical professionals (Such as occupational therapists and dieticians)
N/A
General medical appliances
PMB only
Hearing aids
N/A
Optometry (Once every 2 years)
1 eye test per beneficiary, R115 co-payment
Basic dentistry
1 consultation per beneficiary, R115 co-payment
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 140 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. Additional benefit for medical quarantine up to R10 000 per person if tested positive for Covid-19
Maternity benefits
Amniocentesis
N/A
Antenatal classes
N/A
Antenatal consultations
N/A
Postnatal consultations
N/A
Private ward
N/A
Ultrasound scan 2D
N/A
Childcare benefits
Baby advice line
For children under 3 years
Congenital hypothyroidism screening
N/A
GP consultations (Children between ages 2 and 12)
N/A
Hearing screening
N/A
Immunisations
N/A
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)
0
Mammogram (Every 2 years, women over 40)
0
Pap Smear (Every 3 years, women between ages 21-65)
1
Pneumococcal vaccine (Every 5 years, members aged 65 and over)
0
Prostate screening antigen test (Men between ages 45-69)
0
Stool test for colon cancer (Members between ages 50-75)
0
Bone density screening (Women aged 65 and men aged 70 and over)
0
Whooping cough booster vaccine (Every 10 years, members between 7-64)
0
Human Papillomavirus (HPV) vaccines (Girls between ages 9-14)
0
Wellness benefits
Wellness screening (Benefit includes: GP and specialist consultations, Acute and over-the-counter medicine, Biokineticist and physiotherapist consultations and treatment, Paramedical services such as dietician, speech and occupational therapy consultations and treatment, Alternative healthcare such as homeopathic consultations and treatment and acupuncture, Non-surgical procedures and tests e.g. wart removal, X-rays, Blood tests)
R1 000 per family. Consultations and treatment paid at 100% of the Bonitas Rate. Subject to completion of an online wellness questionnaire or wellness screening
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 2023 Bonitas Product Brochure.
