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Type of Medical Aid Plan: 
New Generation
Medical Aid Year: 
2020
Day to day Benefits: 

Savings available for GP and specialist consultations, acute medicine, x-rays, blood tests, optometry and other out-of hospital expenses. Separate benefit for basic dentistry and mental health consultations

In Hospital Benefits
Are you prepared to use designated hospitals?: 
No
Hospital Rate of Payment: 
Unlimited at 100% of Bonitas Rate (BR)
Hospitals: 

Any

Upfront Payments to hospitals: 

Co-payments apply to certain procedures performed in hospital: R1 520 for minor procedures;
R3 850 for Arthroscopy, Diagnostic Laparoscopy, Laparoscopic Hysterectomy and Percutaneous Rhizotomies;
R7 580 for Back Surgery including Spinal Fusions, Laparoscopic Pyeloplasty, Laparoscopic Radical Prostatectomy and Reflux surgery

Specialists: 
Unlimited at 100% of BR
Other healthcare professionals eg. Physio, Occupational, Dietician: 
Subject to available savings, except for PMB
Radiology and pathology: 
Unlimited at 100% of BR
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy): 
Co-payment of R1 520 applies if performed in-hospital
MRI and CT scans: 
R23 800 per family available, in- or out-of hospital. Subject to pre-authorisation
ICU and High Care: 
Unlimited at 100% of BR
Dialysis: 
Unlimited at 100% of BR. You must use a Designated Service Provider(DSP), or a 20% co-payment will apply
Organ Transplants: 
Unlimited at 100% of BR. Sub-limit of R32 130 for corneal grafts
Oncology / Cancer: 
R344 500 available per family. Subject to the use of a preferred provider. Sub-limit of R44 200 per beneficiary for Brachytherapy
Neck and Back Operations: 
Co-payment of R7 580. Managed Care Protocols apply and the use of a preferred supplier
Joint Replacements: 
No benefit
Prosthesis: 

Internal: R32 130 per family. Managed Care protocols apply and the use of a preferred supplier. External: Subject to available savings

Medical and Surgical Appliances: 
Subject to available savings
Maternity Confinements: 
Unlimited at 100% of BR
In Hospital Dentistry: 
PMB only. Pre-authorisation required
Take home Medicine: 
R390 per beneficiary, per hospital stay
Rehabilitation, Hospice and Step-down facilities: 
Physical rehabilitation R50 600 per family. Hospice and step-down facilities; R16 880 per family. Terminal Care; unlimited
Treatment for Mental Health: 
Hospitalisation; R32 210 per family with R15 890 per family available for In- or out-of-hospital consultations. No cover for physiotherapy for mental health admissions. Subject to the use of a DSP
HIV / AIDS: 
Unlimited if you register on the HIV/AIDS programme. Chronic medicine must be obtained from Pharmacy Direct
Ambulance Service: 
ER24 in an emergency
International Travel Benefit: 
Cover for medical emergencies when you travel outside South Africa. Subject to registration
Day-to-day benefits
GP consultations: 

Subject to available savings. If you use all of your savings for the year, your family will have access to a maximum of 6 GP consultations, limited to 3 per beneficiary, paid at BT

Specialist consultations: 

Subject to available savings and a referral from your GP

Acute medicine: 

Subject to available savings

Over-the-counter (OTC) Medicine: 

Subject to available savings

Optometry benefits: 
Subject to available savings
Basic dentistry: 
Subject to the Bonitas Dental Tariff. 2 annual check-ups per beneficiary; 2 scale and polish treatments, x-rays, fillings, root canal and extractions. Managed Care Protocols apply
Specialised Dentistry: 
No benefit
Orthodontics: 

No benefit

MRI and CT Scans (Out of Hospital): 
R13 260 per family available, in- or out-of hospital. Subject to pre-authorisation
Radiology and Pathology: 
Subject to available savings
Pregnancy benefits: 
6 antenatal consultations with a gynaecologist, GP or midwife, 2 2D scans,1 amniocentesis, 4 consultations with a midwife after delivery. 1 of these may be used for a consultation with a lactation specialist. Maternity support for pregnant moms
Physiotherapy and Occupational Therapy day to day: 
Subject to available savings
Chronic Conditions
Provider: 
Pharmacy Direct and formulary medication. A 40% co-payment applies for non-use of the network pharmacy or formulary
Chronic Conditions: 

Diagnosis, treatment and care costs of 27 chronic conditions that fall under the PMB Chronic Disease List (CDL), issued by the Council for Medical Schemes

Additional Chronic Conditions: 
No benefit
Preventative Care Benefits
Preventative Benefits: 

Contraceptives for women up to 50, limited to R1 610 per family. Subject to the DSP for pharmacy-dispensed contraceptives. CHILDCARE: Hearing screening for newborns, in- or out-of hospital; Congenital hypothyroidism screening for infants under 1 month; Babyline 24/7 helpline for children under 3 years; Paediatrician or GP consultations: 2 per child, per annum, under 1 year and 1 per child up to 2 years; 1 GP consultation per child, from 2 - 12 years; Immunisation according to South African Expanded Programme. OTHER: 1 wellness screening test per beneficiary at a wellness network provider; 1 HIV test and 1 Flu vaccine per beneficiary; Age specific tests for: pap smear; mammogram; prostate screening; pneumococcal vaccine and stool test for colon cancer. Wellness Extender benefit of R1 270 per family available after completing a wellness screening test

Total Contributions
Total Contribution Main Member: 
2723.00
Total Contribution Adult: 
2109.00
Total Contribution Child*: 
815.00
BonSave
Annual Medical Savings Account
Annual Medical Savings Main Member: 
6372.00
Annual Medical Savings Adult: 
4932.00
Annual Medical Savings Child*: 
1908.00
Monthly Medical Savings
Savings Child*: 
159.00
Savings Adult: 
411.00
Savings Main Member: 
531.00
Risk Contributions
Risk Contribution Main Member: 
2192.00
Risk Contribution Adult: 
1698.00
Risk Contribution Child: 
656.00
Medical Aid Plan Name Term: 
BonSave