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
GP consultations
Network: Unlimited, using a maximum of 2 nominated BonCap network GPs. Pre-authorisation required from 8th visit. Non-Network: 1 out-of-network consultation per beneficiary, maximum 2 consultations per family, limited to R380 per visit 30% co-payment applies, unless PMB
Specialist consultations
Network: 3 visits or R3 480 per beneficiary or 5 visits or R5 170 per family. Subject to referral from a BonCap network GP. Pre-authorisation required (including MRIs and CT scans)
X-rays and ultrasounds, blood tests and acute medicine
(Combined benefit) *Ranges from R2 060 - R4 970, *based on family size. Subject to the BonCap formulary, Bonitas pharmacy network and use of a network provider. Acute medicine and blood tests: 20% co-payment at non-DSP
Over-the-counter medicine
R105 per event, R295 per beneficiary per year. Subject to the BonCap medicine formulary, Bonitas pharmacy network and use of a network provider
Paramedical/Allied medical professionals (Such as occupational therapists and dieticians)
PMB only
General medical appliances
R6 330 per famliy
Hearing aids
N/A
Optometry (Once every 2 years)
Glasses or contact lenses are available through the contracted service provider once every 2 years (based on the date of your previous claim). Managed Care protocols apply
Basic dentistry (Subject to dental management protocols)>
Managed Care protocols apply
Specialised dentistry (Subject to dental management protocols)
N/A
Chronic benefits (Subject to Managed Care Protocols)
Unlimited for PMB at the DSP
Additional benefits
Contraceptives (Per family)
R1 180 at the DSP. 40% co-payment applies at non-DSP
International travel
N/A
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
Infants under 1 month old
GP consultations (Children between ages 2 and 12)
N/A
Hearing screening
Newborns up to 8 weeks, in or out-of-hospital
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)
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)
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)
N/A
Wellness screening (Blood pressure, glucose, cholesterol, body mass index and waist-to-hip ratio)
1 wellness screening per beneficiary at a participating pharmacy, biokineticist or a Bonitas wellness day.
Please Note:DSP = Designated Service Provider PMB = Prescribed Minimum Benefits *For full details refer to the 2023 Bonitas Product Brochure.
