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Bonitas BonEssential Medical Aid Plan

Overall, the Bonitas BonEssential Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance to up to 3 Family Members. The Bonitas BonEssential Medical Aid Plan starts from R2,287 ZAR.

💵 Prescribed Minimum Benefits (PMB)	☑️ Yes
📌 Screening and Prevention	☑️ Yes
👤 Main Member Contribution	R2,287 ZAR
👥 Adult Dependent Contribution	R1,690 ZAR
➡️ Gap Cover	☑️ Yes
🚑 Hospital Cover	Unlimited
🏠 Home Care	☑️ Yes
💊 Chronic Conditions	☑️ Yes
🍼 Pre- and Postnatal Care	☑️ Yes
💳 Medical Savings Account	❎ No

Bonitas BonEssential Review – 9 Key Point Quick Overview

Bonitas BonEssential Plan Overview

Overall, 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 BonEssential Plan starts from R2,287.

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

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

Bonitas BonEssential Plan Contributions

🔎 Member	👤 Main Member	👥 +1 Adult Dependent	💙 +1 Child Dependent
💶 Contributions	R2,287 ZAR	R1,690 ZAR	R739 ZAR

Bonitas BonEssential Benefits and Cover Comprehensive Breakdown

Bonitas BonEssentials In-Hospital Benefits

✅ This benefit provides coverage for major medical events resulting in the beneficiary’s hospitalization.
✅ Members have access to coverage at private hospitals participating in the applicable network.
✅ Pre-approval is necessary.
✅ Certain admissions or procedures may be subject to a co-payment.
✅ The Protocols of Managed Care apply.
✅ Using a hospital within the applicable network will exempt you from a 30% co-payment under this option.

🔎 Specialist Consultations in-hospital	Unlimited, with specialists fully covered according to Bonita’s Rate. Non-network specialists are paid up to 100% of Bonita’s Rate.
📌 GP Consultations in-hospital	Unlimited, with 100% cover according to Bonita’s Rate.
📍 Blood Tests and other lab tests	Unlimited, with 100% cover according to Bonita’s Rate.
✔️ X-Rays and Ultrasounds	Unlimited, with 100% cover according to Bonita’s Rate.
✅ MRI and CT scans	There is an R15,170 limit per family in and out-of-hospital. Pre-authorization is required for MRIs and CT scans. There is an R2,660 co-payment per scan unless it is for a PMB.
👁️ Cataract Surgery	Members can avoid an R7,050 co-payment by only using a DSP.
➡️ Allied Medical Professionals	Only PMBs are covered. Subject to referral by a treating physician.
🔍 Physiotherapy, Podiatry, and biokinetics	Only PMBs are covered. Subject to referral by a treating physician.
📎 Internal and External Prostheses	Only PMBs are covered. Bonitas Managed Care Protocols are in effect with this benefit.
🏥 Hospitalization for dentistry	A co-payment of R5,000 per hospital admission for the removal of impacted teeth. Managed Care and admission protocols will apply. General anesthesia benefits are offered for the removal of impacted teeth. Pre-approval is required for this benefit.
💙 Mental Health Hospitalization	There is coverage up to R36,860 per family. Physiotherapy for mental health admissions is not covered.
💊 Take-Home Medicine after discharge	Members receive up to 7 days’ supply, up to R445 per hospital stay
💉 Physical Rehabilitation	There is a limit of up to R57,890 per family.
🚑 Hospitalization Alternatives	There is a limit of R19,310 per household. Managed Care rules apply.
⚕️ Palliative Care (Only for Cancer)	Unlimited but subject to the DSP. Includes hospice and private nursing, oxygen at home, pain management, and support from a psychologist and a social worker.
😷 Cancer Treatment	Unlimited for PMBs with a DSP. There is a 30% co-payment when members use a non-DSP. There is a sub-limit of R57,890 per beneficiary with Brachytherapy.
➡️ Cancer Medicine	Subject to the Medicine Price List and the Preferred Product List Use a Designated Service Provider to avoid a 20% co-payment.
❤️ Organ Transplants	Only PMBs are covered under this benefit.
📌 Kidney Dialysis	Unlimited cover. 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 an R2,590 co-payment.

Bonitas BonEssentials Chronic Benefits

BonEssential 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 BonEssential 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
✅ Diabetes Type 1
✅ Diabetes Type 2
✅ Dysrhythmias

and many more. A full list will be supplied.

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Bonitas BonEssential Plan Additional Benefits

BonEssential Maternity Care

This benefit offers the following:

✅ Six antenatal appointments with a gynecologist, general practitioner, or midwife.
✅ Two 2-dimensional ultrasound scans.
✅ Amniocentesis was performed once.

Four post-delivery midwife consultations (one of which can be used for a lactation specialist consultation).

BonEssential Plan Maternity Programme

With this benefit, members can get the following benefits:

✅ Access to a maternity advice line available around the clock.
✅ Dedicated maternity nurse/midwife to support and advise you during your pregnancy.
✅ Access to articles on prevalent pregnancy issues.
✅ You receive weekly pregnancy education emails and text messages.
✅ Online prenatal classes prepare you for childbirth and what to expect at home.
✅ A Baby bag containing baby care necessities.

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BonEssential Plan Benefit Booster

This benefit provides up to R1,100, which can be used towards any out-of-hospital claims, including the following:

✅ General practitioner and specialist consultations.
✅ Acute and over-the-counter medicine.
✅ Biokineticists and physiotherapist consultations and treatment.
✅ Paramedical services include dietician, speech, and occupational therapy consultations and treatment.
✅ Alternative healthcare such as homeopathic consultations, treatment, and acupuncture.

Once an adult beneficiary has completed a wellness screening or online wellness questionnaire, a child dependent can access the Benefit Booster.

Bonitas BonEssential Plan Wellness Benefit

There is one wellness examination per recipient at a participating pharmacy, biokinetics, or Bonita’s wellness day. The health examination includes the following tests:

✅ Blood pressure
✅ Glucose
✅ Cholesterol
✅ Body Mass Index
✅ Waist-to-hip ratio

BonEssential Plan Preventative Care

This benefit includes the following:

✅ One HIV test and counseling for each recipient.
✅ One flu vaccine per beneficiary.
✅ One complete lipogram every 5 years for individuals aged 20 and older.
✅ One mammogram every two years for women over 40.
✅ Women aged 21 to 65 should undergo a pap smear every three years.
✅ Men between 45 and 69 qualify for one prostate screening antigen test yearly.
✅ Members 65 and older receive 1 pneumococcal vaccine every 5 years.
✅ One stool test for colon cancer for individuals aged 50 to 75.
✅ Dental fissure sealants prevent tooth decay in permanent teeth in children younger than 16 years.

Covid-19 vaccinations and boosters as directed by the National Health Service.

BonEssential Plan Contraceptives

✅ R1,500 per household for the Bonitas BonEssential Plan (for women aged up to 50).
✅ It would help if you used the Designated Service Provider for contraceptives dispensed by a pharmacy.

A 40% co-payment applies if you choose not to use a Designated Service Provider.

Bonitas BonEssential Plan Africa Benefit

This benefit is subject to authorization but provides in-hospital and out-of-hospital treatment at 100% of Bonita’s Rate.

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Bonitas BonEssential Plan Childcare

This benefit offers the following benefits:

✅ Hearing screening for infants up to 8 weeks of age, in or outside the hospital.
✅ Screening for congenital hypothyroidism in infants younger than one month.
✅ Babyline: 24-hour medical advice line for children younger than 3 years.
✅ Immunization according to South Africa’s Expanded Programme on Immunization until the age of 12.

One consultation per child between 2 and 12 years.

Bonitas BonEssential Plan International Travel Benefit

Before departure, you must register for this benefit. The Bonitas BonEssential Plan International Travel Benefit covers up to R10 million in medical emergency cover per family when traveling outside South Africa. Furthermore, an additional benefit for medical quarantine is up to R10,000 per recipient if Covid-19 is detected.

Bonitas BonEssential Plan Hospital-at-Home

This benefit offers the following:

✅ 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, Bonita’s 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.
✅ Re-admissions can be reduced with the help of a transitional care program.

Hospital-at-Home requires prior authorization.

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Bonitas BonEssential Plan Cancer Cover

The Bonitas BonEssential Plan’s Cancer Cover benefit works in the following ways:

✅ Provides you with emotional and medical support.
✅ Consults your physician to confirm that your treatment plan is clinically appropriate for your needs.
✅ Social worker access for you and your loved ones.
✅ Utilizes the Bonitas Oncology Medicine Network. Non-network providers are subject to a 20% co-payment.
✅ Matches your treatment plan to your insurance benefits to ensure you have the necessary coverage.

Specialists from the Bonitas Oncology Network are utilized.

Bonitas BonEssential Plan HIV / AIDS Benefit

This benefit works in the following ways:

✅ Offers appropriate treatment and the means to live your best life.
✅ Provides HIV-related consultations to monitor your doctor’s clinical status.
✅ Provides access to telephone support from physicians.
✅ Includes drugs to prevent mother-to-child transmission and infection following a sexual assault or a needle-stick injury.
✅ Covers routine blood tests to monitor disease progression, therapy response, and possible treatment side effects.
✅ Provides ongoing patient support through a team of skilled and seasoned counselors.
✅ Prevention and treatment of opportunistic infections such as pneumonia, tuberculosis, and influenza.

Finds a registered therapist for face-to-face emotional support.

Diabetes Management

This benefit works in the following ways:

✅ Enables you to make the best decisions to maintain your health.
✅ Offers cover tests necessary for managing diabetes and other chronic conditions.
✅ Provides access to diabetes specialists, dietitians, and podiatrists.
✅ Provides access to a Health Coach who will respond to any questions.
✅ Offers a tailored care plan to meet your specific requirements.

Provides education to improve your understanding of your condition.

Back and Neck Programme

This benefit works in the following ways:

✅ Evaluation of back and neck pain to determine the level of care necessary before surgery for the best possible outcome.
✅ Provides a customized treatment plan for up to six weeks.
✅ Contains care from physicians, physiotherapists, and biokinetics.
✅ Provides access to a home care plan for long-term results maintenance and aids in managing severe back and neck pain.
✅ Highly efficient and low risk, with a high rate of success.
✅ Excluding X-rays, Bonitas will cover the cost of the program.

Members can use the DBC network.

Bonitas BonEssential Plan Exclusions and Waiting Periods

Exclusions

The following is currently not covered by the Bonitas BonEssential 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
✅ Back rests and chair seats
✅ Bandages and dressings (except medicated dressings)
✅ Beds, mattresses, linen savers, pillows, and overlay

and many more.

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Waiting Periods

Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Bonitas BonEssential 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 BonEssential Plan vs. Other Bonitas Medical Fund Plan Options

🔎 Medical Aid Plan	🥇 Bonitas BonEssential Plan	🥈 GEMS Ruby	🥉 POLMED Aquarium
💵 Prescribed Minimum Benefits (PMB)	☑️ Yes	☑️ Yes	☑️ Yes
📌 Screening and Prevention	☑️ Yes	☑️ Yes	☑️ Yes
💳 Medical Savings Account	❎ No	☑️ Yes	❎ No
🍼 Maternity Benefits	☑️ Yes	☑️ Yes	☑️ Yes
👶 Pre- and Postnatal Care	☑️ Yes	☑️ Yes	☑️ Yes
📊 Chronic Conditions	☑️ Yes	❎ No	❎ No
👤 Main Member Contribution	R2,287 ZAR	R3,180 – R3,920 ZAR	R117 – R1,800 ZAR
👥 Adult Dependent Contribution	R1,690 ZAR	R2,385 – R2,955 ZAR	R117 – R1,800 ZAR
💙 Child Dependent Contribution	R739 ZAR	R1,230 – R1,520 ZAR	R50 – R838 ZAR

Our Verdict on the Bonitas BonEssential Plan

The Bonitas BonEssential plan is a comprehensive medical aid plan that offers both in-hospital and day-to-day benefits. This plan is designed for individuals or families who want a comprehensive plan but do not need all the bells and whistles of the more expensive plans.

The BonEssential plan covers preventative and curative care, including chronic medication, dentistry, optometry, maternity benefits, and more. Compared to other plans from Bonitas, the BonEssential plan offers a more affordable option for those who do not require the same level of coverage as the more expensive plans, such as the BonClassic and BonComprehensive plans.

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

Bonitas BonEssential Plan Frequently Asked Questions

Does the BonEssential plan cover in-hospital treatments?

Yes, the BonEssential plan covers in-hospital treatments, including surgeries, diagnostic tests, and other hospital-related expenses.

Does the BonEssential plan cover pregnancy and childbirth?

Yes, the BonEssential plan covers pregnancy and childbirth, including prenatal and postnatal care, hospitalization, the provision of a baby bag, and delivery expenses.

Does the BonEssential plan cover diabetes?

Yes, the BonEssential plan provides cover for the treatment of diabetes, including medication, pathology tests, and other related healthcare services.

Does the BonEssential plan cover HIV?

Yes, the BonEssential plan provides cover for the treatment of HIV, including antiretroviral therapy and related healthcare services.

Do the BonEssential plan cover knee and hip replacement surgery?

No, the BonEssential plan does not currently cover joint replacement surgeries such as knee and hip replacement surgery.

Does the BonEssential plan cover spinal surgery?

Yes, the BonEssential plan covers spinal surgery via its Back and Neck program, which includes an assessment, personalized treatment plan, and more. Home care is another benefit to ensure that members can heal within the comfort of their own homes.

Do the BonEssential plan cover optometry and eye care?

No, BonEssential does not cover out-of-hospital optometry or eye care and only cataract surgery.

Does the BonEssential plan cover dentistry?

Yes, the BonEssential plan covers dentistry, including routine dental check-ups, fillings, extractions, and other dental procedures.

Does the BonEssential plan cover oncology?

BonEssential only covers dentistry hospitalization under general anesthetic, and co-payments might apply.

Does the BonEssential plan offer benefits for families and childcare?

Yes, the BonEssential plan offers a range of benefits for families and childcare, including well-baby and well-child visits, immunizations, and preventative healthcare services.

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.