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
R34 340 per family (In and out-of-hospital) (R2 500 co-payment per scan, except for PMB)
Internal and external prostheses
R60 380 for internal prosthesis per family. R60 380 for external prosthesis per family
Internal nerve stimulators
R181 400 per family
Cochlear implants
R304 300 per family
Mental health hospitalisation
R53 480 per family
Sublimit of hospitalisation for mental health consultations per family (In or out-of-hospital)
R18 130 per family
Take-home medicine
Limited to a 7-day supply up to R595 per hospital stay
Physical rehabilitation
R54 360 per family
Alternatives to hospital (Hospice, step-down facilities)
R18 130 per family
Terminal care
Unlimited for oncology
Cancer treatment
Unlimited for PMBs. R400 000 per family for non-PMBs (30% co-payment applies for use of a non-network provider). R260 600 of this can be used for specialised drugs (including biological drugs)
Unlimited, if you register on the HIV/AIDS programme
Co-payments for certain procedures (Refer to product brochure for details)
Co-payment applies for hip and knee replacements at a non-DSP. Co-payment applies for cataract surgery at a non-DSP
Refractive surgery
R22 760 per family
Out-of-hospital benefit
Overall day-to-day limit
N/A
GP consultations
Paid from available savings and/or above threshold benefit
Specialist consultations
Paid from available savings and/or above threshold benefit
X-rays and ultrasounds
Paid from available savings and/or above threshold benefit
Blood tests
Paid from available savings and/or above threshold benefit
Acute medicine
Paid from available savings and/or above threshold benefit. Medicine limited to R15 930 per family above threshold
Over-the-counter medicine
Paid from available savings and/or above threshold benefit. Medicine limited to R15 930 per family above threshold
Paramedical/Allied medical professionals (Such as occupational therapists and dieticians)
Subject to available savings and/or above threshold benefit
General medical appliances
Subject to available savings and/or above threshold benefit
Hearing aids
R30 000 per family every 5 years (10% co-payment applies)
Optometry (Once every 2 years)
Paid from available savings and/or above threshold benefit. Limited to R3 675 per beneficiary, every 2 years
Basic dentistry (Subject to dental management protocols)
Paid from available savings and/or above threshold benefit
Specialised dentistry (Subject to dental management protocols)
Paid from available savings and/or above threshold benefit
Chronic benefits (Subject to Managed Care Protocols)
60 chronic conditions. R16 100 per beneficiary. R32 060 per family
Additional benefits
Contraceptives (Per family)
R1 830
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
1
Antenatal classes
R1 410
Antenatal consultations
12
Postnatal consultations
4 (1 can be used for a consultation with a lactation specialist)
Private ward
Yes
Ultrasound scan 2D
2
Childcare 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)
2
Hearing screening
For newborns up to 8 weeks, in or out-of-hospital
Immunisations
According to the Expanded Programme on Immunisation in South Africa
Paediatric consultations (Infants between ages 1 and 2)
2
Paediatric consultations (Infants under the age of 1)
3
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 Smear (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
Whooping cough booster vaccine (Every 10 years, members between 7-64)
1
Human Papillomavirus (HPV) vaccines (Girls between ages 9-14)
2
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)
R2 730 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.
