IN-HOSPITAL BENEFITS
This benefit offers cover for major medical events that result in a beneficiary being admitted to hospital . Members have access to the applicable hospital network . Pre-authorisation is required . Managed Care protocols apply . Please note : On these options you can avoid a R12 050 co-payment by using a hospital on the applicable network .
PRIVATE HOSPITAL CARE |
Unlimited at the applicable hospital network |
R1 690 co-payment per admission , except for PMB emergencies |
Unlimited at the applicable hospital network |
R1 130 co-payment per admission , except for PMB emergencies |
GP CONSULTATIONS |
Unlimited , covered at 100 % of the Bonitas Rate |
Unlimited , covered at 100 % of the Bonitas Rate |
SPECIALIST CONSULTATIONS |
Unlimited , covered at 100 % of the Bonitas Rate |
Unlimited , covered at 100 % of the Bonitas Rate |
BLOOD TESTS |
R29 350 per family except for PMB |
Unlimited , covered at 100 % of the Bonitas Rate |
BLOOD TRANSFUSIONS |
R21 320 per family except for PMB |
Unlimited , covered at 100 % of the Bonitas Rate |
X-RAYS AND ULTRASOUNDS |
Unlimited , covered at 100 % of the Bonitas Rate |
Unlimited , covered at 100 % of the Bonitas Rate |
MRIS AND CT SCANS ( SPECIALISED RADIOLOGY )
R13 390 per family Pre-authorisation required R18 180 per family Pre-authorisation required R2 660 co-payment per scan event except for PMB
R2 130 co-payment per scan event except for PMB
ALLIED MEDICAL PROFESSIONALS ( SUCH AS DIETICIAN , SPEECH AND OCCUPATIONAL THERAPIST ) |
PMB only |
Subject to referral by treating practitioner |
PMB only |
Subject to referral by treating practitioner |
PHYSIOTHERAPY AND BIOKINETICS |
PMB only |
Subject to referral by treating practitioner |
PMB only |
Subject to referral by treating practitioner |
CHILDBIRTH
Unlimited at the applicable hospital network
Avoid a R12 050 co-payment by using a hospital on the applicable network
Unlimited at the applicable hospital network
Avoid a R12 050 co-payment by using a hospital on the applicable network
Emergency approved C-sections only Managed Care protocols apply Emergency approved C-sections only Managed Care protocols apply
NEONATAL CARE Limited to R52 360 per family except for PMB Limited to R52 360 per family except for PMB
INTERNAL PROSTHESES PMB only Managed Care protocols apply
R18 180 per family ( no cover for joint replacement except for PMB )
Managed Care protocols apply Pre-authorisation required
EXTERNAL PROSTHESES PMB only PMB only
MENTAL HEALTH HOSPITALISATION ( ALSO SEE CARE PROGRAMMES PAGE 9 )
PMB only
No cover for physiotherapy for mental health admissions
Avoid a R12 050 co-payment by using a hospital on the applicable network
PMB only
No cover for physiotherapy for mental health admissions
Avoid a R12 050 co-payment by using a hospital on the applicable network TAKE-HOME MEDICINE Limited to a 7-day supply up to R440 per hospital stay Limited to a 7-day supply up to R440 per hospital stay PHYSICAL REHABILITATION R57 230 per family Pre-authorisation required R57 230 per family 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
11 BONSTART & BONSTART PLUS 2024 IN-HOSPITAL BENEFITS