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Overall, the Bonitas Standard Select Medical Aid Plan is a trustworthy and comprehensive medical aid plan that offers 24/7 medical emergency assistance and Gap Cover to up to 3 Family Members. The Bonitas Standard Select Medical Aid Plan starts from R4,448 ZAR.
The Bonitas Standard Select starts from R4,448 and includes cover for maternity, in- and out-of-hospital, international travel, PMBs, and more.Β Gap Cover is available on the Bonitas Standard Select Plan, along with 24/7 medical emergency assistance.
According to the Trust Index, Bonitas Medical Fund has a trust rating of 4.5.
π€ Main Member | π₯ +1 Adult Dependent | π +1 Child Dependent |
R4,448 ZAR | R3,849 ZAR | R1,302 ZAR |
The Bonitas Standard Select Medical Plan offers access to day-to-day benefits that cover GP and specialist consultations, acute medicine, X-rays, blood tests, and other out-of-hospital medical expenses up to the overall day-to-day limit, subject to the category-specific sub-limit.
Bonitas Standard Select Plan members must note that once they complete the wellness screening or the online questionnaire, the Benefit Booster is activated and can be used to pay for out-of-hospital expenses first.
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The day-to-day benefits cover GP and specialist consultations, acute medicine, X-rays, blood tests, and other out-of-hospital medical expenses up to the overall day-to-day limit, subject to the category-specific sublimity.Β Tests and consultations for PMB treatment plans are covered under a different benefit, which will not affect your regular coverage.
π Members | βοΈ Day-to-Day Benefits |
π€ Main Member (Only) | R12,780 |
π₯ Main Member + 1 Dependent | R19,170 |
π Main Member + 2 Dependents | R21,300 |
β‘οΈ Main Member + 3 (or more) Dependents | R23,430 |
β‘οΈ The sub-limits below represent the maximum allowed for each category, subject to the total daily limit.
π Feature | 1οΈβ£ GP and Specialist Consultations | 2οΈβ£ Acute and OTC Medicine | 3οΈβ£ Radiology and Pathology | 4οΈβ£ Auxiliary Services |
π Feature Overview | Specialist consultations require GP referral (Including telemedicine) | Avoid a 20% co-payment using a Bonitas Pharmacy Network or formulary medicine. Over-the-counter medicine is limited to R800 per beneficiary and R2,500 per family. | This category includes blood, lab, X-ray, and ultrasound tests. | This category includes physiotherapy, podiatry, biokinetics, allied medical professionals (dieticians, speech, and occupational therapists), and alternative healthcare (20% co-payment for homeopathic medicine). |
π€ Main Member | R3,200 | R3,200 | R3,200 | R3,200 |
π₯ Main Member + 1 Dependent | R4,790 | R4,790 | R4,790 | R4,790 |
π Main Member + 2 Dependents | R5,330 | R5,330 | R5,330 | R5,330 |
β‘οΈ Main Member + 3 Dependents or more | R6,390 | R6,390 | R6,390 | R6,390 |
β‘οΈ The sub-limits below represent the maximum allowed for each category, subject to the total daily limit.
π©Ί General Medical Appliances | Stoma Care and CPAP machines have a daily limit of R8 130 per family. Managed Care CPAP machines Managed Care protocols limit frequency. Use the preferred supplier. |
𦻠Hearing Aids | R8 650 per family every 5 years (based on the date of your previous claim). There is a 25% co-payment that applies on non DSP. After the family limit is exceeded, the balance is subject to the daily limit. |
βοΈ MRIs and CT scans | There is a limit of R32,340 per family, in and out of the hospital. Pre-authorization is needed. There is a co-payment of R1,770 per scan event where needed, except for PMB. |
π Mental Health Consultations | The mental health hospitalization benefit covers consultations in and out of the hospital. The benefit is limited to R19,310 per family. |
π Insulin Pump / Continuous Glucose Monitoring (Type 1 / 2 Diabetes for members <18 years) | Covered up to R85,000 per family every 5 years. Consumables are limited to R85,000 per family. One family device per year. |
ποΈ Optometry | R7 385 per family every two years (based on your last claim). Beneficiaries must choose either glasses or contacts. |
ποΈβπ¨οΈ Eye Tests | Each beneficiary is entitled to one combined consultation with a network provider. Alternatively, they can have an eye examination at a non-network provider for a fee of R380. |
π€ Single Vision Lenses | The cost of lenses is covered up to 100% according to network rates. There is a limit of R215 per beneficiary per lens if an out-of-network provider is used. |
π Bifocal Lenses | The cost of lenses is covered up to 100% according to network rates. There is a limit of R460 per beneficiary per lens if an out-of-network provider is used. |
βοΈ Multifocal Lenses | The cost of base lenses is covered up to 100%. Alternatively, it is limited to R860 per designer lens per beneficiary regardless of whether it is in or out-of-network. |
β Frames | R1,340 per recipient at a network provider or R1,005 per recipient at a non-network provider. |
β³οΈ Contact Lenses | R2,060 per person (included in the family limit) |
π¦· Basic Dentistry | Covered by the Bonitas Dental Tariff if the Bonitas Dental Management Program is followed. |
πͺ₯ Consultations | 2 check-ups per recipient per year (once every 6 months) |
β‘οΈ Intra-Oral X-Rays | The Bonitas Managed Care Protocols will apply. |
βοΈ Extra-Oral X-Rays | One allowed per beneficiary every 3 years. |
π· Preventative Care | 2 scale and polish treatments per recipient per year (once every 6 months). Crack fillers are only covered for kids younger than 16 years old. Fluoride treatments are only paid for kids under 16 and under 5 years old. |
π Fillings | Benefits for fillings are given once every two years for each tooth. Protocols for Managed Care decide whether a tooth can be treated again or not. If you need more than one filling, you may need a treatment plan and X-rays. |
π Root Canal Therapy and Extractions | The rules for Managed Care apply. |
π¦· Plastic Dentures and Various Laboratory Costs | One set of plastic dentures (upper and lower) every 4 years for each person who gets them. Pre-authorization required. |
π Specialized Dentistry | The Bonitas Dental Tariff covers this benefit. |
π Partial Chrome Cobalt Frame Dentures and Associated Lab Costs | One partial frame (upper or lower) per patient, once every 5 years. Pre-authorization is needed for this. |
π Crowns, Bridges, Lab Costs | There is a limit of one crown per household per year. Crowns will be covered once per tooth every five years. Requests for a treatment plan and X-rays are possible. Pre-authorization is needed. |
π© Orthodontics, Lab Costs | Orthodontic treatment is provided once per lifetime beneficiary. Cases requiring pre-approval will be clinically evaluated using an orthodontic needs analysis. Up to 80% of the Bonitas Dental Tariff may be covered based on the findings of a needs assessment. Orthodontic treatment will be covered when a function is compromised (not granted for cosmetic reasons). Only one family member may initiate orthodontic treatment per year. The benefit of fixed comprehensive treatment is restricted to beneficiaries aged 9 to 18. Application of Managed Care protocols. Pre-authorization is required. |
β‘οΈ Periodontics | Benefits are restricted to conservative, non-surgical therapy and will only be applied to members who are enrolled in the Periodontal Programme Managed Care protocols apply. Pre-authorization is required. |
π€ Surgery in the dentistβs rooms | Bonitasβ Managed Care Protocols Apply |
π΄ Hospitalization and general anesthetic | A co-payment of R3,500 per hospital admission for children younger than 5 years of age and R5,000 for all other admissions and the application of admission protocols are required. For extensive dental treatment, children under five may only receive general anesthesia once in their lifetime. General anesthesia is covered for the extraction of impacted teeth. Utilize a hospital within the applicable network to avoid a 30% co-payment. Managed Care protocols apply. Pre-authorization is required for this procedure. |
π Inhalation sedation in the dentistβs room | Managed Care Protocols will apply. |
π Moderate/Deep Sedation in the dentistβs room | This is according to the extensive dental treatment limit. The Bonitas Managed Care Protocols will apply. This procedure requires pre-authorization. |
Standard Select provides cover for the 45 chronic conditions listed below, up to R11,910 per beneficiary and R23,900 per family, as specified by the applicable formulary. You must obtain your medication from Pharmacy Direct, a 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. Furthermore, members should note that authorization in advance is required.
You will continue to be covered for the 27 Prescribed Minimum Benefits listed below through Pharmacy Direct, the Designated Service Provider, once the above amount has been exhausted.Β 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.
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Furthermore, The Bonitas Standard Select Plan Covers the following PMBs.
and many more.
The following additional conditions are covered under the Bonitas Standard Select Plan:
and many more.
Available upon completion of a wellness questionnaire or screening. There is an R5,000 limit per family that can be used for a range of out-of-hospital claims, including the following:
When an adult recipient has completed a wellness screening or online wellness questionnaire, dependent children are eligible for the Benefit Booster.
This benefit offers the following:
Four postpartum consultations with a midwife (1 can be used for a consultation with a lactation specialist).
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With this benefit, members can get the following benefits:
A Baby bag containing baby care necessities.
There is one wellness examination per recipient at a participating pharmacy, biokinetics, or Bonita’s wellness day. The health examination includes the following tests:
This benefit includes the following:
Two human papillomaviruses (HPV) vaccinations for girls aged 9 to 14 years
A 40% co-payment applies if you choose not to use a Designated Service Provider.
This benefit is subject to authorization but provides in-hospital and out-of-hospital treatment at 100% of Bonita’s Rate.
This benefit offers the following benefits:
Immunization according to South Africaβs Expanded Programme on Immunization until the age of 12.
Before departure, you must register for this benefit. The Bonitas Standard Select Plan International Travel Benefit covers up to R10 million in medical emergency cover per family when traveling outside South Africa.Β Furthermore, an additional benefit for medical quarantine is up to R10,000 per recipient if Covid-19 is detected.
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This benefit offers the following:
Hospital-at-Home requires prior authorization.
The Bonitas Standard Select Plan Cancer Cover benefit works in the following ways:
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Specialists from the Bonitas Oncology Network are utilized.
This benefit works in the following ways:
Finds a registered therapist for face-to-face emotional support.
This benefit works in the following ways:
Provides education to improve your understanding of your condition.
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This benefit works in the following ways:
Members can use the DBC network.
This benefit works in the following ways:
Full cover is provided by the ICPS and Joint Care networks.
This benefit covers major medical events resulting in the beneficiaryβs hospitalization. In addition, members have access to private hospital coverage. Authorization in advance is required. A co-payment may be required for certain admissions or procedures. Furthermore, the benefits are subject to Managed Care Protocols.
π©Ί GP Consultations in-hospital | Unlimited, with 100% cover according to Bonita’s Rate. Unlimited non-network specialists are compensated at 100% of Bonita’s Rate. |
βοΈ Specialist Consultations in-hospital | Unlimited, with 100% cover according to Bonita’s Rate. |
π©Έ Blood Tests | Unlimited, with 100% cover according to Bonita’s Rate. |
π °οΈ Blood Transfusions | Unlimited, with 100% cover according to Bonita’s Rate. |
π ±οΈ X-Rays and Ultrasounds | Unlimited, with 100% cover according to Bonita’s Rate. |
π§ͺ MRI and CT scans | There is a R32,340 limit per family in and out-of-hospital. Pre-authorization is required for MRIs and CT scans. There is an R1,770 co-payment per scan unless it is for a PMB. |
π Allied Medical Professionals | Subject to a referral from a treating physician. Subject to the Auxiliary Services Benefit Sub-limit unless it is a PMB. |
π Physiotherapy, Podiatry, and biokinetics | Subject to a referral from a treating physician. Subject to the Auxiliary Services Benefit Sub-limit unless it is a PMB. |
π Internal and External Prostheses | There is a limit of R54,780 per family unless PMB applies. Subject to Managed Care Protocols. There is a sub-limit of R6,520 per breast prosthesis, limited to 2 yearly. |
βοΈ Spinal Surgery | This is subject to an assessment or conservative treatment by a DSP. |
𦡠Hip and Knee Replacements | There is an R35,250 co-payment if members use a non-DSP. |
βοΈ Internal Nerve Stimulators | There is a yearly limit of R205,100 for this benefit. |
𦻠Cochlear Implants | Only PMBs are covered. |
ποΈ Cataract Surgery | Members can avoid an R7,050 co-payment by only using a DSP. |
π Mental Health Hospitalization | There is coverage up to R49,330 per family. Physiotherapy for mental health admissions is not covered. Utilize a hospital within the applicable network to avoid a 30% co-payment. |
π Take-Home Medicine after discharge | Members receive up to 7 daysβ supply, up to R575 per hospital stay |
β³οΈ Physical Rehabilitation | There is a limit of up to R61,480 per family. Pre-authorization is required. |
π Hospitalization Alternatives | There is a limit of R20,500 per household. Managed Care rules apply. |
π 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. |
π€ Cataract Surgery | If you use the Designated Service Provider, you can avoid an R7,050 co-payment. |
π· Cancer Treatment | Unlimited for PMBs. Bonitas covers up to R266,300 per family for non-PMBs, which is paid up to 80%, according to the DSP. There is no cover for non-DSPs once the limit is reached. There is a 30% co-payment when members use a non-DSP. There is a sub-limit of R57,680 that applies per beneficiary for Brachytherapy. |
β‘οΈ Cancer Medicine | Subject to the Medicine Price List and the Preferred Product List Use a Designated Service Provider to avoid a 20% co-payment. |
β€οΈ Organ Transplants | Unlimited cover. Sub-limit of R39,040 applies per beneficiary for corneal grafts. |
βοΈ Kidney Dialysis | Unlimited cover. Members can avoid a 20% co-payment by using a DSP. |
βοΈ HIV/AIDS | If you register for HIV/AIDS, the cover is unlimited. Buying chronic medicine from the Designated Service Provider avoids a 30% co-payment. |
β Defined List of Day Surgery Procedures | Use a network day hospital to avoid an R5,170 co-payment. |
The following is currently not covered by the Bonitas Standard Select Plan:
and many more.
Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with the Bonitas Standard Select Plan:
A late-joiner contribution penalty fee will apply.
π Medical Plan | π₯ Bonitas Standard Select Plan | π₯ Momentum Incentive | π₯ GEMS Emerald |
π€ Main Member Contribution | R4,448 | R2,794 – R4,970 | 2,975 β 3,689 ZAR |
π₯ Adult Dependent Contribution | R3,849 | R3,866 – R6,908 (2 Adults) | 2,273 β 2,836 ZAR |
π Child Dependent Contribution | R1,302 | R3,866 β R6,908 (1A & 1C) | 1,106 β 1,382 ZAR |
π₯ Hospital Cover | Unlimited | Unlimited | Unlimited |
βοΈ Oncology Cover | R250,000 | R400,000 | R242,300 |
πΆ Prescribed Minimum Benefits (PMB) | βοΈ Yes | βοΈ Yes | βοΈ Yes |
β‘οΈ Screening and Prevention | βοΈ Yes | βοΈ Yes | βοΈ Yes |
π Home Care | βοΈ Yes | βοΈ Yes | None |
π Gap Cover | βοΈ Yes | βοΈ Yes | None |
The Bonitas Standard Select Plan offers several benefits that can be found on the Bonitas Standard Plan, including unlimited hospital coverage and treatments and procedures that are covered, given that members use network providers and facilities.
However, stricter conditions apply to some of the treatments on the Bonitas Standard Select Plan, subjecting members to co-payments if these conditions are not met.Β However, with the Bonitas Standard Select, members can enjoy a wide range of benefits that reassure them that emergencies are covered, and they have access to routine care for their families.
You might also like to consider the following plans Bonitas has to offer:
The Bonitas Medical Aid Standard Select Plan is a more cost-effective medical aid option that covers hospitalization, chronic medication, and routine medical expenses.
The Bonitas Medical Aid Standard Select Plan includes hospitalization, chronic medication, routine medical expenses, consultations with specialists, radiology, pathology, and maternity benefits.
The price of the Bonitas Medical Aid Standard Select Plan varies based on a few variables, such as the number of dependents, pre-existing conditions, etc.
Yes, there is a 3-month waiting period for all benefits except for accidents and medical emergencies.
Yes, you can choose your own healthcare providers; however, you may incur higher costs if you choose a non-network provider.
You can enroll in the Bonitas Medical Aid Standard Select Plan by visiting their website, completing an application form, and submitting the required paperwork.
Yes, the Bonitas Medical Aid Standard Select Plan covers pre-existing conditions. However, certain conditions may be subject to waiting periods or exclusions.
The coverage is limited and is funded by major medical benefits. Bonitas provides limited benefits for stays in transitional care facilities and hospices. Depending on the type of plan subscribed, the cover is paid using in-hospital benefits.
Re-treatment benefits for a tooth are subject to managed care protocols. Included in the BDT. Multiple fillings might necessitate a treatment plan and radiographs. Treatments for Root Canals and Extractions The benefit is subject to managed care protocols.
All plans cover the 27 conditions on the Chronic Disease List (CDL) at 100% MSR (Medical Scheme Rate), subject to a formulary. The cover must be requested via the Bonitas Call Centre and is restricted to a Designated Service Provider (DSP), Pharmacy Direct.
Yes, Bonitas covers this under mental health. Depending on your plan, you can get consultations and several other services.
Bonitas provides all pregnant members with a beautiful baby bag to celebrate the birth of their child. The baby bag contains items for you and your infant. This could consist of diapers, baby wipes, a blanket or toy, bath products, and other toiletries, subject to availability.
You must register with Bonitas and complete the Pharmacy Direct registration form. Once complete, you can submit it to Bonitas.
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