OUT-OF-HOSPITAL BENEFITS
These benefits provide cover for consultations with your GP or specialist , acute medicine , X-rays , blood tests and other out-of-hospital medical expenses . Please note : When you complete a wellness screening or online wellness questionnaire , you unlock the Benefit Booster which can be used to pay for out-of-hospital expenses first . See page 8 for more information .
BONCOMPREHENSIVE BONCOMPLETE
MAIN MEMBER
ADULT DEPENDANT
CHILD DEPENDANT
MAIN MEMBER
ADULT DEPENDANT
SAVINGS R22 308 R21 036 R4 536 R9 624 R7 716 R2 616 SELF-PAYMENT GAP R4 950 R4 110 R1 870 R2 150 R1 820 R470 THRESHOLD LEVEL R27 258 R25 146 R6 406 R11 774 R9 536 R3 086 ABOVE THRESHOLD BENEFIT UNLIMITED R5 710 R3 350 R1 460
CHILD DEPENDANT
Once your savings for the year are finished , you will need to pay for day-to-day medical expenses yourself , until you have paid the full self-payment gap . You will then have access to your above threshold benefit . Please submit all claims you have paid towards the self-payment gap to us , so that we can let you know when you have access to your above threshold benefit . Please note that not all claims accumulate to your self-payment gap . Claims will accumulate at the Bonitas Rate .
GP CONSULTATIONS ( INCLUDING VIRTUAL CARE CONSULTATIONS )
BONCOMPREHENSIVE
Paid from available savings and / or above threshold benefit
BONCOMPLETE
Paid from available savings and / or above threshold benefit
SPECIALIST CONSULTATIONS |
Paid from available savings and / or above threshold benefit |
You must get a referral from your GP |
Paid from available savings and / or above threshold benefit |
You must get a referral from your GP |
EMERGENCY ROOM BENEFIT ( NEW ) ( FOR EMERGENCIES ONLY ) |
2 emergency consultations per family at a casualty ward or emergency room facility of a hospital |
If it is not classified as an emergency , it will be paid from available savings and / or above threshold benefit |
2 emergency consultations per family at a casualty ward or emergency room facility of a hospital |
If it is not classified as an emergency , it will be paid from available savings and / or above threshold benefit |
NON-SURGICAL PROCEDURES Paid from available savings and / or above threshold benefit Paid from available savings and / or above threshold benefit
BLOOD TESTS AND OTHER LABORATORY TESTS
Paid from available savings and / or above threshold benefit
Paid from available savings and / or above threshold benefit
X-RAYS AND ULTRASOUNDS Paid from available savings and / or above threshold benefit Paid from available savings and / or above threshold benefit
MRIs AND CT SCANS ( SPECIALISED RADIOLOGY )
R36 570 per family , in and out-of-hospital
R2 660 co-payment per scan event except for PMB
Pre-authorisation required
R28 930 per family , in and out-of-hospital
R2 660 co-payment per scan event except for PMB
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
3 BONCOMPREHENSIVE & BONCOMPLETE 2024 OUT-OF-HOSPITAL BENEFITS