ACUTE MEDICINE
OVER-THE-COUNTER MEDICINE
HOMEOPATHIC MEDICINE
ALLIED MEDICAL PROFESSIONALS ( SUCH AS DIETICIAN , SPEECH AND OCCUPATIONAL THERAPIST )
PHYSIOTHERAPY , PODIATRY AND BIOKINETICS
MENTAL HEALTH CONSULTATIONS ( ALSO SEE CARE PROGRAMMES PAGE 11 )
GENERAL MEDICAL APPLIANCES ( SUCH AS WHEELCHAIRS AND CRUTCHES )
INSULIN PUMP OR CONTINUOUS GLUCOSE MONITOR ( ALSO SEE CARE PROGRAMMES PAGE 11 )
BONCOMPREHENSIVE
Paid from available savings and / or above threshold benefit
20 % co-payment for non-network or non-formulary use in above threshold benefit
Paid from available savings and / or above threshold benefit
20 % co-payment for non-network or non-formulary use in above threshold benefit
Paid from available savings and / or above threshold benefit
Subject to available savings and / or above threshold benefit
Subject to available savings and / or above threshold benefit
In and out-of-hospital consultations ( included in the mental health hospitalisation benefit )
Paid from available savings
R85 000 per family every 5 years
Formulary and Bonitas Pharmacy Network applies to above threshold benefit
Above threshold limit of R16 970 per family combined with over-the-counter medicine
Formulary and Bonitas Pharmacy Network applies to above threshold benefit
Above threshold limit of R16 970 per family combined with acute medicine
A 20 % co-payment applies when paid from above threshold benefit
Limited to R19 310 per family
Subject to frequency limits as per Managed Care protocols
Consumables limited to R85 000 per family
BONCOMPLETE
Paid from available savings and / or above threshold benefit
Formulary and Bonitas Pharmacy Network applies to above threshold benefit
20 % co-payment for non-network or non-formulary use in above threshold benefit
Paid from available savings and / or above threshold benefit
Formulary and Bonitas Pharmacy Network applies to above threshold benefit
20 % co-payment for non-network or non-formulary use in above threshold benefit
Paid from available savings and / or above threshold benefit
Subject to available savings and / or above threshold benefit
Subject to available savings and / or above threshold benefit
In and out-of-hospital consultations ( included in the mental health hospitalisation benefit )
Paid from available savings and / or above threshold benefit
R85 000 per family every 5 years
A 20 % co-payment applies when paid from above threshold benefit
Limited to R19 310 per family
Subject to frequency limits and Managed Care protocols
Consumables limited to R85 000 per family
Limited to one device per type 1 diabetic for beneficiaries younger than 18 Limited to one device per type 1 diabetic for beneficiaries younger than 18
AUDIOLOGY ( HEARING AIDS , CONSULTATIONS AND TESTS ) ( ALSO SEE CARE PROGRAMMES PAGE 12 )
IN-ROOM PROCEDURES
OPTOMETRY
R10 300 per device ( maximum two devices per beneficiary ), once every 3 years ( based on the date of your previous claim )
All tests and consultations limited to the Audiology Benefit Management Programme and use of a network provider
Cover for a defined list of approved procedures performed in the specialist ’ s rooms
Paid from available savings and / or above threshold benefit , limited to R3 860 per beneficiary , once every 2 years ( based on the date of your previous claim )
Avoid a 25 % co-payment by using a Designated Service Provider
Claims outside the Audiology Benefit Management Programme paid from available savings and / or above threshold benefit
Pre-authorisation required
Each beneficiary can choose glasses
OR contact lenses
R9 200 per device ( maximum two devices per beneficiary ), once every 3 years ( based on the date of your previous claim )
All tests and consultations limited to the Audiology Benefit Management Programme and use of a network provider
Cover for a defined list of approved procedures performed in the specialist ’ s rooms
Paid from available savings and / or above threshold benefit , once every 2 years ( based on the date of your previous claim )
Avoid a 25 % co-payment by using a Designated Service Provider
Claims outside the Audiology Benefit Management Programme paid from available savings and / or above threshold benefit
Pre-authorisation required
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 |
1 consultation per beneficiary , at a network provider |
OR |
R380 per beneficiary for an eye examination , at a non-network provider |
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 BONCOMPREHENSIVE & BONCOMPLETE 2024 OUT-OF-HOSPITAL BENEFITS