User login

You are here

Home

BONITAS BONESSENTIAL SELECT 2019

Add to compare
Type of Medical Aid Plan: 
Hospital
Medical Aid Year: 
2019
Day to day Benefits: 

Not benefit.

In Hospital Benefits
Hospital Rate of Payment: 
consultations & treatment at 100% of the Bonitas Rate
Hospitals: 

Members have access to certain network hospitals. A 30% co-payment may apply to admissions at specific hospitals.

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.

A co-payment will apply to the following procedures in hospital:

R1 450 co-payment:

Colonoscopy, Conservative Back Treatment, Cystoscopy, Facet Joint Injections, Flexible Sigmoidoscopy, Functional Nasal Surgery, Gastroscopy, Hysteroscopy(not Endometrial Ablation), Myringotomy, Tonsillectomy and Adenoidectomy, Umbilical Hernia Repair, Varicose Vein Surgery.

R3 680co-payment:

Arthroscopy, Diagnostic Laparoscopy, Laparoscopic Hysterectomy, Laparoscopic Appendectomy, Percutaneous Radiofrequency Ablations (Percutaneous Rhizotomies).

R7 250 co-payment:

Back Surgery including Spinal Fusion, Joint Replacements, Laparoscopic Pyeloplasty, Laparoscopic Radical Prostatectomy, Nissen Fundoplication (Reflux Surgery).

Casualty / Emergency Visits: 
No benefit.
Specialists: 
Unlimited, network specialists covered in full at the Bonitas Rate Unlimited, non-network specialists paid at 100% of the Bonitas Rate
Other healthcare professionals eg. Physio, Occupational, Dietician: 
Unlimited, covered at 100% of the Bonitas Rate Your therapist must get a referral from the doctor treating you in hospital
Radiology and pathology: 
Unlimited, covered at 100% of the Bonitas Rate.
Scopes (gastroscopy, colonoscopy, sigmoidoscopy and proctoscopy): 
R1 450 co-payment
MRI and CT scans: 
MRIs and CT scans (specialised radiology) R15 750 per family Pre-authorisation required
ICU and High Care: 
Unlimited, covered at 100% of the Bonitas Rate.
Dialysis: 
Unlimited You must use a Designated Service Provider, or a 20% co-payment will apply
Organ Transplants: 
Unlimited Sublimit of R31 500 per beneficiary for corneal grafts
Oncology / Cancer: 
R344 500 per family You must use a preferred provider Sublimit of R44 220 per beneficiary for Brachytherapy
Neck and Back Operations: 
R7 250 co-payment
Joint Replacements: 
R7 250 co-payment
Prosthesis: 

Internal prosthesis

R31 500 per family (excluding joint replacement prosthesis)
Managed Care protocols apply

You must use a preferred supplier

Medical and Surgical Appliances: 
No benefit
Maternity Confinements: 
6 Antenatal consultations (GPm gynaecologist, midwife), 2 x 2D ultrasound scans, 1 amniocentesis, 4 midwife consults after delivery, Bonitas baby bag (after pre authorisation registration)
In Hospital Dentistry: 
No benefit
Take home Medicine: 
R380 per person per hospital stay
Rehabilitation, Hospice and Step-down facilities: 
Physical rehabilitation R49 610 per family Alternatives to hospital (hospice, step-down facilities) R16 550 per family
Treatment for Mental Health: 
Physical rehabilitation R49 610 per family Alternatives to hospital (hospice, step-down facilities) R16 550 per family
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: 

Not applicable.

On Wellness extender. R910 per family. Once each adult beneficiary has completed a wellness screening, you may choose from additional benefits which include GP consultation(s)

Specialist consultations: 

Not applicable.

On Wellness extender. R910 per family. Once each adult beneficiary has completed a wellness screening, you may choose from additional benefits which include GP consultation(s)

Acute medicine: 

Not applicable.

On Wellness extender. R910 per family. Once each adult beneficiary has completed a wellness screening, you may choose from additional benefits which include GP consultation(s)

Over-the-counter (OTC) Medicine: 

Not applicable.

On Wellness extender. R910 per family. Once each adult beneficiary has completed a wellness screening, you may choose from additional benefits which include GP consultation(s)

Optometry benefits: 
Not benefit.
Basic dentistry: 
Not benefit.
Specialised Dentistry: 
Not benefit.
Orthodontics: 

Not benefit.

MRI and CT Scans (Out of Hospital): 
No benefit.
Radiology and Pathology: 
No benefit.
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)
Physiotherapy and Occupational Therapy day to day: 
R910 per family which can be used for consultations and treatment Each adult beneficiary must complete a wellness screening to access the wellness extender Child dependants can access the wellness extender once an adult beneficiary has completed screening
Chronic Conditions
Provider: 
If you choose not to use the Designated Service Provider or if you choose to use medicine that is not on the formulary, you will have to pay a 40% co-payment.
Chronic Conditions: 

BonEssential Select ensures that you are covered for the 27 Prescribed Minimum Benefi ts listed below on the applicable formulary.

Pre-authorisation is required.

If you choose not to use the Designated Service Provider or if you choose to use medicine that is not on the formulary, you will have to pay a 40% co-payment.

Please note: For HIV/AIDS medicine, you must use the Designated Service Provider or you will have to pay a 40% co-payment.

Prescribed Minimum Benefits covered:

1. Addison’s Disease
2. Asthma
3. Bipolar Mood Disorder
4. Bronchiectasis
5. Cardiac Failure
6. Cardiomyopathy
7. Chronic Obstructive Pulmonary Disease
8. Chronic Renal Disease
9. Coronary Artery Disease
10. Crohn’s Disease
11. Diabetes Insipidus
12. Diabetes Type 1
13. Diabetes Type 2
14. Dysrhythmias
15. Epilepsy
16. Glaucoma
17. Haemophilia
18. HIV/AIDS
19. Hyperlipidaemia
20. Hypertension
21. Hypothyroidism
22. Multiple Sclerosis
23. Parkinson’s Disease
24. Rheumatoid Arthritis
25. Schizophrenia
26. Systemic Lupus Erythematosus
27. Ulcerative Colitis

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

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: 
1477.00
Total Contribution Adult: 
1130.00
Total Contribution Child*: 
433.00
Bonitas 2019 BonEssential Select
Medical Aid Plan Name Term: 
Any