User login

You are here

Home

BONITAS PRIMARY SELECT 2019

Add to compare
Medical Aid Year: 
2019
Day to day Benefits: 

These benefits provide cover for consultations with your specialist, acute medicine, x-rays, blood
tests and other out-of-hospital medical expenses.
There is a separate benefit for tests and consultations for PMB treatment plans (excluding GP
consultations). Therefore this will not affect your day-to-day benefits.
Main member only R2 310
Main member + 1 dependant R4 140
Main member + 2 dependants R4 860
Main member + 3 dependants R5 230
Main member + 4 or more dependants R5 660

In Hospital Benefits
Hospital Rate of Payment: 
100% of the Bonitas Rate
Hospitals: 

Hospital network applies

Upfront Payments to hospitals: 

R1 450 co-payment

1. Colonoscopy

2. Conservative Back
Treatment

3. Cystoscopy

4. Facet Joint Injections

5. Flexible Sigmoidoscopy

6. Functional Nasal Surgery

7. Gastroscopy

8. Hysteroscopy
(not Endometrial Ablation)

9. Myringotomy

10. Tonsillectomy and Adenoidectomy

11. Umbilical Hernia Repair
12. Varicose Vein Surgery

 

R3 680 co-payment

1. Arthroscopy

2. Diagnostic Laparoscopy

3. Laparoscopic
Hysterectomy

4. Laparoscopic
Appendectomy

5. Percutaneous
Radiofrequency
Ablations
(Percutaneous Rhizotomies)

 

R7 250 co-payment

1. Back Surgery including
Spinal Fusion

3. Laparoscopic
Pyeloplasty

4. Laparoscopic Radical
Prostatectomy

5. Nissen Fundoplication
(Reflux Surgery)

Specialists: 
Paid from available day-to-day benefits You must get a referral from your GP
Other healthcare professionals eg. Physio, Occupational, Dietician: 
Paid from available day-to-day benefits
MRI and CT scans: 
R13 000 per family, in and out-of-hospital Pre-authorisation required
Dialysis: 
Unlimited You must use a Designated Service Provider, or a 20% co-payment will apply
Organ Transplants: 
PMB only
Oncology / Cancer: 
R165 500 per family You must use a preferred provider Sublimit of R44 220 per beneficiary for Brachytherapy
Prosthesis: 

R31 500 per family (excluding joint replacement prosthesis)
Managed Care protocols apply
You must use a preferred supplier

Medical and Surgical Appliances: 
R6 890 per family An additional R6 550 per family will apply should Stoma Care and CPAP machines exceed the general medical appliances limit You must use a preferred supplier
In Hospital Dentistry: 
A co-payment of R3 500 per hospital admission and admission protocols apply
Take home Medicine: 
R380 per beneficiary, per hospital stay
Rehabilitation, Hospice and Step-down facilities: 
R16 550 per family
Treatment for Mental Health: 
R9 560 per family In and out-of-hospital consultations (included in the mental health hospitalisation benefit) Cover for educational psychologists for beneficiaries up to the age of 21 years
HIV / AIDS: 
Unlimited, if you register on the HIV/AIDS programme Chronic medicine must be obtained from Pharmacy Direct
International Travel Benefit: 
R5 million per beneficiary R10 million per family Including cover for mandatory vaccines You must register for this benefit
Day-to-day benefits
GP consultations: 

Unlimited, covered at 100% of the Bonitas Rate

Specialist consultations: 

Unlimited, network specialists covered in full at the Bonitas Rate
Unlimited, non-network specialists paid at 100% of the Bonitas
Rate

Acute medicine: 

Paid from available day-to-day benefits

Over-the-counter (OTC) Medicine: 

R490 per beneficiary
R1 430 per family
Paid from available day-to-day benefits

Optometry benefits: 
R4 480 per family, once every 2 years (based on the date of your previous claim) Each beneficiary can choose glasses or contact lenses
Basic dentistry: 
Covered at the Bonitas Dental Tariff You must use a provider on the DENIS network
MRI and CT Scans (Out of Hospital): 
R13 000 per family, in and out-of-hospital Pre-authorisation required
Pregnancy benefits: 
6 antenatal consultations with a gynaecologist, GP or midwife 2 2D ultrasound scans 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)
Chronic Conditions
Provider: 
You must use Pharmacy Direct, our Designated Service Provider, to get your medicine. If you choose not to use Pharmacy Direct or if you choose to use medicine that is not on the formulary, you will have to pay a 40% co-payment.
Chronic Conditions: 

1. Addison’s Disease 10. Crohn’s Disease 19. Hyperlipidaemia
2. Asthma 11. Diabetes Insipidus 20. Hypertension
3. Bipolar Mood Disorder 12. Diabetes Type 1 21. Hypothyroidism
4. Bronchiectasis 13. Diabetes Type 2 22. Multiple Sclerosis
5. Cardiac Failure 14. Dysrhythmias 23. Parkinson’s Disease
6. Cardiomyopathy 15. Epilepsy 24. Rheumatoid Arthritis
7. Chronic Obstructive
Pulmonary Disease

16. Glaucoma 25. Schizophrenia
8. Chronic Renal Disease 17. Haemophilia 26. Systemic Lupus
Erythematosus
9. Coronary Artery Disease 18. HIV/AIDS 27. Ulcerative Colitis

Preventative Care Benefits
Preventative Benefits: 

Preventative care
General health 1 HIV test per beneficiary
1 flu vaccine per beneficiary

Women’s health 1 mammogram every 2 years, for women over 40
1 pap smear every 3 years, for women between ages 21 and 65
Men’s health 1 prostate screening antigen test for men between ages 45 and
69, who are considered to be at high risk for prostate cancer

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

Total Contributions
Total Contribution Main Member: 
1904.00
Total Contribution Adult: 
1489.00
Total Contribution Child*: 
606.00
PRIMARY SELECT
Risk Contributions
Risk Contribution Main Member: 
1904.00
Risk Contribution Adult: 
1489.00
Risk Contribution Child: 
606.00
Medical Aid Plan Name Term: 
Any