Hospital Rate of Payment:
Upfront Payments to hospitals:
A 30% co-payment may apply to admissions at specific hospitals.
Kidney dialysis: You must use a Designated Service Provider, or a 20% co-payment will apply.
In Hospital Dentistry, A co-payment of R3 500 per hospital admission and admission protocol...
Casualty / Emergency Visits:
1 specific (emergency) consultation for pain and sepsisper beneficiary
Specialists:
Unlimited, covered at 100% of the Bonitas Rate
Other healthcare professionals eg. Physio, Occupational, Dietician:
PMB onlyYour therapist must have a referral from the doctor treating you
Radiology and pathology:
R11 840 per familyPre-authorisation required
Dialysis:
UnlimitedYou must use a Designated Service Provider, or a20% co-payment will applyPre-authorisation required
Oncology / Cancer:
Uses the ICON network of oncology specialistsUses the Bonitas Oncology Medicine Network(20% co-payment applies for use of a non-network provider)
Medical and Surgical Appliances:
R5 550 per familyYou must use a preferred supplier
In Hospital Dentistry:
You must use a provider on the DENIS networkCovered at the Bonitas Dental TariffManaged Care protocols apply
Take home Medicine:
Limited to R95 per eventMaximum of R270 per beneficiary, per yearFormulary and Bonitas Pharmacy Network applies(20% co-payment for non-network or non-formulary use)
Rehabilitation, Hospice and Step-down facilities:
R50 600 per familyPre-authorisation required
Treatment for Mental Health:
PMB onlyNo cover for physiotherapy for mental health admissionsSubject to using the Designated Service Provider
HIV / AIDS:
Provides you with appropriate treatment and tools to live anormal lifeCovers medicine to treat HIV (including drugs to preventmother-to-child transmission and infection after sexual assaultor needle-stick injury). Response to therapy and to detec...
International Travel Benefit:
Cover for medical emergencies when you travel outside SouthAfricaYou must register for this benefit
