Boncomprehensive & Boncomplete 2024 | 页面 7

CHRONIC BENEFITS

BONCOMPREHENSIVE
BonComprehensive offers cover for the 60 chronic conditions listed below . Your chronic medicine benefit is R17 150 per beneficiary and R34 140 per family on the applicable medicine formulary . If you choose to use medicine that is not on the formulary , you will have to pay a 40 % co-payment . Once the amount above is finished , you will still be covered for the 27 Prescribed Minimum Benefits , listed below .
You must get your medicine from a Bonitas Network Pharmacy or Pharmacy Direct , our Designated Service Provider . Preauthorisation is required .
PRESCRIBED MINIMUM BENEFITS COVERED
& BONCOMPLETE
BonComplete offers cover for 32 chronic conditions , using the applicable medicine formulary . You must use Pharmacy Direct , our Designated Service Provider , to get your medicine . If you choose not to use Pharmacy Direct or if you choose to use medicine that is not on the formulary , you will have to pay a 40 % co-payment .
Pre-authorisation is required .
1 .
Addison ’ s Disease
10 .
Crohn ’ s Disease
19 .
Hyperlipidaemia
2 .
Asthma
11 .
Diabetes Insipidus
20 .
Hypertension
3 .
Bipolar Mood Disorder
12 .
Diabetes Type 1
21 .
Hypothyroidism
4 .
Bronchiectasis
13 .
Diabetes Type 2
22 .
Multiple Sclerosis
5 .
Cardiac Failure
14 .
Dysrhythmias
23 .
Parkinson ’ s Disease
6 .
Cardiomyopathy
15 .
Epilepsy
24 .
Rheumatoid Arthritis
7 .
Chronic Obstructive Pulmonary Disease
16 .
Glaucoma
25 .
Schizophrenia
8 .
Chronic Renal Disease
17 .
Haemophilia
26 .
Systemic Lupus Erythematosus
9 .
Coronary Artery Disease
18 .
HIV / AIDS
27 .
Ulcerative Colitis
ADDITIONAL CONDITIONS COVERED BONCOMPREHENSIVE
28 . Acne 39 . Dermatomyositis 50 . Obsessive Compulsive Disorder 29 . Allergic Rhinitis 40 . Depression 51 . Osteoporosis 30 . Alzheimer ’ s Disease ( early onset ) 41 . Eczema 52 . Paget ’ s Disease 31 . Ankylosing Spondylitis 42 . Gastro-Oesophageal Reflux Disease ( GORD ) 53 . Panic Disorder 32 . Anorexia Nervosa 43 . Generalised Anxiety Disorder 54 . Polyarteritis Nodosa 33 . Attention Deficit Disorder ( in children aged 5-18 ) 44 . Gout 55 . Post-Traumatic Stress Disorder 34 . Barrett ’ s Oesophagus 45 . Huntington ’ s Disease 56 . Pulmonary Interstitial Fibrosis 35 . Behcet ’ s Disease 46 . Hyperthyroidism 57 . Psoriatic Arthritis 36 . Bulimia Nervosa 47 . Myasthenia Gravis 58 . Systemic Sclerosis 37 . Cystic Fibrosis 48 . Narcolepsy 59 . Tourette ’ s Syndrome 38 . Dermatitis 49 . Neuropathies 60 . Zollinger-Ellison Syndrome
BONCOMPLETE
28 . Acne ( children up to 21 years ) 30 . Allergic Dermatitis / Eczema ( children up to 21 years ) 32 . Depression ( medication up to R150 per beneficiary , per month ) 29 . Allergic Rhinitis ( children up to 21 years ) 31 . Attention Deficit Disorder ( in children aged 5-18 )
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
7 BONCOMPREHENSIVE & BONCOMPLETE 2024 CHRONIC BENEFITS