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Bonitas BonCap Medical Aid Plan (🇿🇦 2025)

Overall, the Bonitas BonCap Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance to its members. The Bonitas BonCap Medical Aid Plan starts from R1, 554

🔎 Plan	🥇 Bonitas BonCap
💊 Prescribed Minimum Benefits	✅ Yes
💻 Screening and Prevention	✅ Yes
💳 Medical Savings Account	❎ No
🍼 Maternity Benefits	✅ Yes
🏥 Hospital Cover	Unlimited
🏠 Home Care	✅ Yes
📌 Optometry Benefit	✅ Yes
📍 Chronic Conditions	✅ Yes
📊 Annual Limit	Unlimited

Bonitas BonCap Review – A 10 Key Point Quick Overview

☑️ Bonitas BonCap Overview
☑️ Bonitas BonCap Plan Contributions
☑️ Bonitas BonCap Benefits and Cover Comprehensive Breakdown
☑️ Surgical Procedures not covered by the BonCap plan
☑️ BonCap Chronic Benefits
☑️ Bonitas BonCap Managed Care Programmes
☑️ Bonitas BonCap Plan Exclusions and Waiting Periods
☑️ Bonitas BonCap Plan vs. Other Bonitas Medical Fund Plan Options
☑️ Our Verdict on the Bonitas BonCap Plan
☑️ Bonitas BonCap Plan Frequently Asked Questions

Bonitas BonCap Overview

The Bonitas Medical Fund is a popular medical aid scheme in South Africa, registered with the Council of Medical Schemes (CMS) under FSP No. 1512. The Bonitas BonCap Plan is an income based plan and starts from R1,554.

It includes maternity, in- and out-of-hospital cover, international travel, PMBs, and more. Gap Cover is available on the Bonitas BonCap Plan, along with 24/7 medical emergency assistance.

According to the Trust Index, Bonitas Medical Fund has a trust rating of 4.5.

🔎 Plan	🥇 Bonitas BonCap
💊 Prescribed Minimum Benefits	✅ Yes
💻 Screening and Prevention	✅ Yes
💳 Medical Savings Account	❎ No
🍼 Maternity Benefits	✅ Yes
🏥 Hospital Cover	Unlimited
🏠 Home Care	✅ Yes
📌 Optometry Benefit	✅ Yes
📍 Chronic Conditions	✅ Yes
📊 Annual Limit	Unlimited

👉🏿 Download the Boncap Medical Aid Plan for 2025 from Bonitas.

Bonitas BonCap Plan Contributions

🔎 Income Level	👤 Main Member	👥 +1 Adult Dependent	👶 +1 Child Dependent
💴 R0 – R11,250	R1,554	R1,554	R732
💵 R11,251 – R18,250	R1,897	R1,897	R872
💶 R18,251 – R23,740	R3,058	R3,058	R1,157
💷 >R23,741+	R3,753	R3,753	R1,424

Bonitas BonCap Benefits and Cover Comprehensive Breakdown

BonCap Out-of-Hospital Benefits – General

1️⃣ Network GP Consultations	Unlimited GP consultations with a maximum of two BonCap network GPs. Approval is required beginning with the eighth GP consultation per beneficiary.
2️⃣ Non-Network GP Consults	One consultation outside of the network per beneficiary. Maximum of two consultations per family, with an R400 fee per visit. Unless it is a PMB, a 30% co-payment is required.
3️⃣ GP-referred acute medicine, X-Rays, and Pathology	R2,300 – Main member. R3,840 – Main member + 1 dependent Main member plus two dependents – R4,600 The main member and three dependents – R5,020 Primary member plus four or more dependents – R5,570 Subject to the terms of the applicable formulary and the Bonita’s pharmacy network for emergency medicine and blood tests: Non-DSP patients must pay a 20% co-payment.
4️⃣ Network Specialist Consultations	Each beneficiary is limited to three visits or R3 900. Five visits are permitted, or a maximum of up to R5,800 per family (whichever is first). Pre-authorization is required, subject to the BonCap Specialist network and referral from a BonCap network GP (including MRIs and CT scans)
5️⃣ Maternity Care	The benefits cover antenatal consultations for GP consultations and specialist consultations (including 2 2D scans) 4 post-delivery midwife consultations (1 of which can be used for a lactation specialist consultation)
6️⃣ Over-the-counter Medicine	Each event is limited to R115. A maximum of R330 per beneficiary per year is allowed. The BonCap medicine formulary, the Bonita’s pharmacy network, and the use of a network provider are all subject to the BonCap medicine formulary.
7️⃣ Allied Medical Professionals, including occupational therapists, dieticians, etc.	Only PMB conditions are covered under this benefit.
8️⃣ Physiotherapy, Podiatry, and biokinetics	Only PMB conditions are covered.
9️⃣ General Medical Appliances	There is a limit of up to R7,090 per family, subject to certain frequency limits according to the Managed Care Protocols.

BonCap Out-of-Hospital Benefits – Optometry

🤓 Optometry	Once every two years, glasses or contact lenses are available through the contracted service provider (based on the date of your previous claim) Managed Care protocols will apply.
👁️ Eye Tests	One consultation composite per beneficiary with a network provider or R400 per recipient for an eye exam with a non-network provider.
👁️‍🗨️ Single-vision lenses (Clear)	100% contribution to the cost of lenses at network rates of R215 per lens per beneficiary.
Bifocal lenses (Clear)	100% of the cost of lenses at network rates of R460 per lens per beneficiary.
👓 Multifocal lenses	100% towards the cost of base lenses at a network provider, or a maximum of R860 per designer lens, per beneficiary, out-of-network.
📌 Frames	R275 per recipient with a network provider OR R195 per recipient with a non-network provider
📍 Contact Lenses	There is a limit of up to R1,295 per beneficiary.

BonCap Out-of-Hospital Benefits – Basic Dentistry

🦷 Basic Dentistry	Members must use a provider registered on the Bonitas DENIS network. Covered according to the Bonitas Dental Tariff. Managed Care protocols will apply.
🪥 Consultations	There is only one consult available per beneficiary yearly.
📌 Emergency Consultation	There is one emergency consultation for sepsis per beneficiary on the plan.
📍 Intra-Oral X-Rays	Four X-Rays per beneficiary.
Extra-Oral X-Rays	Only covers PMBs.
🪥 Scaling and polishing	There is one scaling and polishing or one polish per beneficiary.
📌 Fluoride Treatment	There is a single treatment per beneficiary from 5 to <36 years.
📍 Fissure Sealants	One fissure sealant per tooth once every 3 years and only for beneficiaries <16 years.
📈 Infection Control, Sterilization of instruments, and local anesthetic	One per beneficiary per visit.
🪥 Inhalation sedation in the dentist’s room	Only Managed Care protocols apply to extensive conservative dental treatment when inhalation sedation is used.
📌 Emergency Root Canal	This only applies to emergency treatment and is subject to the DENIS treatment protocols.
📍 Extractions	Subject to DENIS protocol for treatment, and if impacted wisdom teeth are not removed
📈 Plastic dentures and lab fees	Beneficiaries are eligible once every two years. Applies to those 21 years or older (depending on the date of your previous claim). Managed Care protocols are in effect. A 20% co-payment is required. Pre-authorization is required, or a 20% penalty will be imposed.
🪥 Dental fillings	Four fillings for each beneficiary. Fillings are covered once every two years per tooth. The benefit of tooth re-treatment is subject to Managed Care protocols.
📌 Maxillo-Facial Surgery in the dental chair	Only PMBs are covered, and pre-authorization is necessary according to the DENIS protocols.
📍 Moderate or deep sedation in the dentist’s rooms	This benefit is limited to extensive conservative dental treatments, and pre-authorization must be obtained according to the DENIS protocols
📈 Hospitalization and general anesthetic	This only covers PMBs, and pre-authorization is necessary from DENIS. Furthermore, members must use a hospital on the relevant network to avoid a 10% co-payment.

BonCap Additional Benefits

Contraceptives For Women up to 50

✅ R1 330 for each family.
✅ For pharmacy-dispensed contraceptives, you must use the Designated Service Provider.
✅ If you do not use a Designated Service Provider, you must pay a 40% co-payment.

Childcare

Hearing Screenings

✅ Available for newborns up to 8 weeks.
✅ It can be done in or out-of-hospital.

Congenital Hypothyroidism Screening

✅ It can be done for infants <1 month.

Baby line

✅It can be done for infants <1 month.

👉🏿 READ more: 5 Best Medical Aids for Babies in South Africa

Preventative Care

General Health

✅ There is one HIV test and counseling available per beneficiary.
✅ There is one flu vaccine yearly per beneficiary.

Women’s Health

✅ Women over 40 have access to 1 mammogram every two years.
✅ Women between 21 and 65 have access to a pap smear every 3 years.
✅ 2 Human Papillomavirus (HPV) vaccines, female beneficiaries between ages 9 and 14 (one course per lifetime)
✅ 3 Human Papillomavirus (HPV) vaccines, female beneficiaries between ages 15 and 26 (one course per lifetime)

Men’s Health

✅ There is one prostate antigen test for male beneficiaries between 55 and 69.

Elderly Health

✅ Members 65 and over get one pneumococcal vaccine every 5 years.
✅ Members between 45 and 75 receive 1 stool test for colon cancer, subject to the applicable formulary.

Dental Fissure Sealants

✅ Available per tooth, once every 3 years per beneficiary <16 years.

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Wellness Benefits

✅ There is one wellness screening offered to each beneficiary at a participating pharmacy, Bonita’s wellness day, or biokinetics.
✅ Wellness includes blood pressure, glucose, cholesterol, BMI, and waist-to-hip ratio.

Africa Benefits Per Trip

Treatment in and out-of-hospital is covered at 100% of the Bonitas rate, subject to authorization.

BonCap In-Hospital Benefits

100% of the BonCap Rate is covered for hospitalizations at all hospitals within the applicable network. You must get pre-authorization for your hospital admission.

If you use a non-network hospital (other than in an emergency) or do not receive pre-authorization within 48 hours of admission, you will be responsible for a 30% co-payment.

Furthermore, Managed Care Protocols could apply.

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🔎 GP Consultations in-hospital	Unlimited, with 100% covered according to the BonCap Rate for BonCap network GPs. Where non-network GPs are used, the cover will be up to 70% of the BonCap rate.
📌 Specialist Consultations in-hospital	Unlimited, with 100% covered in terms of the BonCap Rate for BonCap network GPs. Where non-network GPs are used, the cover will be up to 70% of the BonCap rate.
📍 Blood Tests and other lab tests	Subject to a limit of R31,230 per family unless it is a PMB.
☑️ Blood Transfusions	Up to R22,690 per family unless it is a PMB.
✅ X-Rays and Ultrasounds	Unlimited, with 100% cover according to the BonCap rate.
🔎 MRI and CT scans	There is an R14,250 limit per family, and pre-authorization is required.
📌 Cataract Surgery	There is an R7,420 co-payment when using a non-DSP.
📍 Allied Medical Professionals	Only PMBs will be covered. There is a 30% co-payment when using a non-DSP. Subject to referral by your treating physician.
☑️ Physiotherapy, Podiatry, and biokinetics	Only PMBs will be covered. There is a 30% co-payment when using a non-DSP. Subject to referral by your treating physician.
✅ Internal and External Prostheses	Only PMBs will be covered if you use a DSP. Managed Care protocols will apply. Pre-authorization is mandatory for any procedures.
🔎 Mental Health Hospitalization	Only PMBs are covered, and there is no cover for physiotherapy. You must use a DSP, or a 30% co-payment will apply.
📌 Neonatal Care	There is a limit of R55,710 per family unless it is a PMB.
📍 Take-Home Medicine after discharge	Members receive up to 7 days’ supply, up to R470 per hospital stay
☑️ Physical Rehabilitation	There is a limit of up to R60,900 per family, and pre-authorization is required.
✅ Hospitalization Alternatives	There is a limit of R17,550 per family. Pre-authorization is required.
🔎 Palliative Care (Only for Cancer)	Unlimited but subject to the DSP. Pre-authorization is mandatory. Includes hospice and private nursing, oxygen at home, pain management, and support from a psychologist and a social worker.
📌 Cancer Treatment	Only PMBs are covered; members must use a DSP or pay a 30% co-payment. Pre-authorization is needed.
📍 Cancer Medicine	Subject to the Preferred Product List Use a Designated Service Provider to avoid a 20% co-payment.
☑️ Organ Transplants	Only PMBs are covered, and you must use a DSP. Pre-authorization is mandatory.
✅ Kidney Dialysis	Unlimited cover. You need pre-authorization for all procedures. Members can avoid a 20% co-payment by using a DSP.
🔎 HIV/AIDS	If you register for HIV/AIDS, the cover is unlimited. Medicine must be obtained from a DSP.
📌 Defined List of Day Surgery Procedures	Use a network day hospital to avoid a 30% co-payment.

Surgical Procedures not covered by the BonCap Plan

⛔ Back and neck surgery
⛔ Joint replacement surgery
⛔ Cesarean sections done for non-medical reasons
⛔ Functional nasal and sinus surgery
⛔ Varicose vein surgery
⛔ Hernia repair surgery
⛔ Laparoscopic or keyhole surgery Gastroscopies
⛔ Colonoscopies and all other endoscopies
⛔ Bunion surgery In-hospital dental surgery

BonCap Chronic Benefits

BonCap provides coverage for the 27 Prescribed Minimum Benefits outlined in the applicable formulary. You must obtain your medication from Pharmacy Direct, the Bonitas Designated Service Provider.

If you choose not to use Pharmacy Direct or if you use an off-formulary medication, you will be responsible for a 40% co-payment.

The Bonitas BonCap Plan Covers the following PMBs:

✅ Addison’s Disease
✅ Asthma
✅ Bipolar Mood Disorder
✅ Bronchiectasis
✅ Cardiac Failure
✅ Cardiomyopathy
✅ Chronic Obstructive Pulmonary Disease
✅ Chronic Renal Disease
✅ Coronary Artery Disease
✅ Crohn’s Disease
✅ Diabetes Insipidus
✅ Tuberculosis
✅ Multiple Sclerosis

and many more.

Bonitas BonCap Managed Care Programmes

⚕️ Cancer	This benefit puts you first, providing emotional and medical assistance. Matches your treatment plan to your insurance benefits to ensure you have the necessary coverage. Consults with your physician to confirm that your treatment plan is clinically appropriate for your needs. Specialists from the Bonitas Oncology Network are utilized. Social worker access for you and your loved ones Utilizes the Bonitas Oncology Medicine Network (30% co-payment applies for out-of-network use).
💊 HIV/AIDS	Offers appropriate treatment and the means to live your best life. Covers routine blood tests to monitor disease progression, therapy response, and possible treatment side effects. Provides HIV-related consultations to monitor your doctor’s clinical status. Provides ongoing patient support through a team of skilled and seasoned counselors. Provides access to telephone support from physicians. Prevention and treatment of opportunistic infections such as pneumonia, tuberculosis, and influenza Includes drugs to prevent mother-to-child transmission and infection following a sexual assault or a needle-stick injury. Finds a registered therapist for face-to-face emotional support.
🍼 Maternity Support when registering for the Bonitas Maternity Programme	24/7 access to maternity advice line. Weekly pregnancy education emails and SMS are sent to you. Dedicated maternity nurse/midwife to provide support and guidance throughout your pregnancy. Online prenatal classes prepare you for labor and what to expect at home. Access to articles on prevalent pregnancy issues. A baby bag containing essentials for baby care. New for 2025: Early identification of high-risk pregnancies. Weekly engagement for high-risk pregnancies. Post-childbirth follow-up calls. Online assessments for pregnancy and mental health.
💙 Hospital at Home	Care for any acute condition deemed necessary by your treating physician, such as pneumonia or Covid-19. Alternative to general ward admission and step-down facilities, enabling patients to receive quality, safe healthcare in the comfort of their own homes. Remote patient monitoring, including round-the-clock monitoring of vital signs from our clinical command center, continuous virtual visits and clinical support, continuous care from a physician, short-term oxygen (as prescribed), and emergency ambulance services. In addition to remote patient monitoring, daily visits, laboratory services, blood tests, wound dressings, medication/fluids via a drip, allied healthcare services, and physiotherapy, our hospital setup at home also includes remote patient monitoring (as prescribed) A team of trained medical professionals, including skilled nurses, will bring all the essential elements of hospital care to your home. A transitional care program to minimize re-admissions
♀️ Female Health	New for 2025: Accessible to all female members aged 18 and above Guidance, support, and education led by women’s healthcare experts. Early detection of diseases and seamless access to specialised carew. Proactive support in accessing essential healthcare services. Promotion of preventative healthcare strategies tailored to women’s needs. Online health assessments tailored to female health concerns. Empowerment of women to actively manage their health

Bonitas BonCap Plan Exclusions and Waiting Periods

Exclusions

The following is currently not covered by the Bonitas BonCap Plan:

⛔ Aromatherapy
⛔ Ayurvedics
⛔ Herbalists
⛔ Iridology
⛔ Reflexology
⛔ Therapeutic Massage Therapy (Masseurs)
⛔ Ambulance Services that are not authorized or already included in the contract with the provider
⛔ Appliances, devices, and procedures not scientifically proven or appropriate
⛔ Backrests and chair seats

and many more. A complete list will be supplied when requested from Bonitas.

👉🏿 READ: 10 Things to Consider Before Cancelling your Medical

Waiting Periods

Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Bonitas BonCap Plan:

✅ A 3-month general waiting period in respect of all benefits.
✅ A 12-month exclusion in respect of a pre-existing condition.

A late-joiner contribution penalty will apply.

Bonitas BonCap Plan vs. Other Bonitas Medical Fund Plan Options

Bonitas Plan Option	Bonitas BonCap Plan (2025)	Discovery Health Essential Dynamic Smart (2025)	Medshield MediCurve (2025)
Prescribed Minimum Benefits (PMB)	☑️ Yes	☑️ Yes	☑️ Yes
Screening and Prevention	☑️ Yes	☑️ Yes	☑️ Yes
Medical Savings Account	❎ No	❎ No	❎ No
Maternity Benefits	☑️ Yes	☑️ Yes	☑️ Yes
Pre and Postnatal Care	☑️ Yes	☑️ Yes	☑️ Yes
Chronic Conditions	☑️ Yes	☑️ Yes	☑️ Yes
Home Care	☑️ Yes	☑️ Yes	☑️ Yes
Oncology Cover	Unlimited for PMBs Pre-authorisation required	R250,000	☑️ Yes
Extended Cover for Oncology	❎ No	☑️ Yes	☑️ Yes
Hospital Cover	Unlimited	Unlimited	PMB is unlimited, and non-PMB has a 25% co-payment for non-MediCurve network hospitals
Optometry Benefit	☑️ Yes (Basic)	☑️ Yes	☑️ Yes
Dentistry Benefit	☑️ Yes (Basic)	☑️ Yes	☑️ Yes
Advanced Dentistry	❎ No	❎ No	☑️ Yes

Our Verdict on the Bonitas BonCap Plan

💙 The Bonitas BonCap medical aid plan is a basic healthcare plan offering limited day-to-day benefits but covering in-hospital treatments.

💙 The plan is designed to provide affordable healthcare coverage to individuals and families who do not require extensive day-to-day benefits.

💙 Compared to other plans from Bonitas, the BonCap plan is more affordable but provides less comprehensive coverage.

You might also like to consider the following plans Bonitas has to offer:

Frequently Asked Questions

What is the BonCap plan?

The BonCap plan is a basic healthcare plan that offers limited day-to-day benefits and in-hospital coverage.

What benefits does the BonCap plan offer?

The BonCap plan covers in-hospital treatments, including hospital accommodation, theatre costs, and medication. It also provides limited day-to-day benefits, such as GP and specialist consultations, prescribed medication, and basic radiology and pathology.

Is the BonCap plan affordable?

Yes, the BonCap plan is more affordable compared to other plans from Bonitas, making it a good option for individuals and families who are looking for basic healthcare coverage at an affordable price.

Does the BonCap plan cover chronic conditions?

The BonCap plan does not provide extensive coverage for chronic conditions. However, it does cover the initial consultation with a specialist to confirm a chronic condition.

Can I add a dependent to my BonCap plan?

Yes, you can add a dependent to your BonCap plan.

Are there waiting periods for the BonCap plan?

Yes, there are waiting periods for certain benefits under the BonCap plan. The waiting periods will depend on the benefit you are claiming for.

Can I upgrade my BonCap plan?

Yes, you can upgrade your BonCap plan to a more comprehensive plan if you require more extensive day-to-day benefits.

Are students eligible for Boncap medical aid plan in South Africa?

Yes, students in South Africa are generally eligible for the Boncap medical aid plan. To be eligible for Boncap, students will need to meet the scheme’s eligibility requirements, which may include being registered as a full-time student at a recognized institution and meeting any other criteria set by the scheme

Who can be a dependent on Boncap Medical Aid?

In general, the following individuals may be eligible to be registered as dependents on a Boncap medical aid plan:

Spouses or life partners of the main member
Children, including biological, adopted, or stepchildren, up to a certain age or until they are financially independent
Extended family members, such as siblings, parents, or grandparents, in certain cases and under specific circumstances, such as when they are financially dependent on the main member or have a medical condition that requires ongoing treatment.

Can I put my sister on my Boncap medical aid?

The eligibility of siblings to be registered as dependents on a Boncap medical aid plan in South Africa may depend on the specific plan you have chosen. In general, some Boncap medical aid plans may allow siblings to be registered as dependents if they meet certain eligibility criteria, such as being financially dependent on the main member or having a medical condition that requires ongoing treatment.

It’s best to contact Boncap directly to confirm their eligibility requirements for siblings and to get more information about their specific plans and coverage options. They will be able to provide you with detailed information about their policies regarding adding siblings as dependents and any associated costs or requirements.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.