Bonclassic 2024 | Page 4

OPTOMETRY
R6 440 per family , once every 2 years ( based on the date of your previous claim )
Each beneficiary can choose glasses OR contact lenses
EYE TESTS 1 consultation per beneficiary , at a network provider OR R380 per beneficiary for an eye examination , at a non-network provider SINGLE VISION LENSES ( CLEAR ) OR 100 % towards the cost of lenses at network rates R215 per lens , per beneficiary , out of network BIFOCAL LENSES ( CLEAR ) OR 100 % towards the cost of lenses at network rates R460 per lens , per beneficiary , out of network MULTIFOCAL LENSES 100 % towards the cost of base lenses at a network provider , or limited to a maximum of R860 per designer lens , per beneficiary , in and out of network
FRAMES R1 280 per beneficiary at a network provider OR R960 per beneficiary at a non-network provider CONTACT LENSES
R2 065 per beneficiary , included in family limit BASIC DENTISTRY R5 812 per family Covered at the Bonitas Dental Tariff
CONSULTATIONS 2 annual check-ups per beneficiary ( once every 6 months ) X-RAYS : INTRA-ORAL X-RAYS : EXTRA-ORAL
PREVENTATIVE CARE
Managed Care protocols apply 1 per beneficiary , every 3 years
2 annual scale and polish treatments per beneficiary ( once every 6 months )
Fluoride treatments are only covered for children from age 5 and younger than 16 years
Fissure sealants are only covered for children under 16 years
FILLINGS
ROOT CANAL THERAPY AND EXTRACTIONS
PLASTIC DENTURES AND ASSOCIATED LABORATORY COSTS
Benefit for fillings is granted once per tooth , every 2 years A treatment plan and X-rays may be required for multiple fillings Managed Care protocols apply
1 set of plastic dentures ( an upper and a lower ) per beneficiary , once every 4 years
Pre-authorisation required
Benefit for re-treatment of a tooth is subject to Managed Care protocols
Managed Care protocols apply
SPECIALISED DENTISTRY R6 997 per family , per year Covered at the Bonitas Dental Tariff
PARTIAL CHROME COBALT FRAME DENTURES AND ASSOCIATED LABORATORY COSTS
2 partial frames ( an upper and a lower ) per beneficiary , once every 5 years
Pre-authorisation required
Managed Care protocols apply
CROWNS , BRIDGES AND ASSOCIATED LABORATORY COSTS
1 crown per family , per year Benefit for crowns will be granted once per tooth , every 5 years A treatment plan and X-rays may be requested
Pre-authorisation required
All benefits and limits are per calendar year , unless otherwise stated . Managed Care protocols apply . All benefits are approved by the Council for Medical Schemes . PMB = Prescribed Minimum Benefits
4 BONCLASSIC 2024 OUT-OF-HOSPITAL BENEFITS