ALTERNATIVES TO HOSPITAL ( HOSPICE , STEP-DOWN FACILITIES )
R16 480 per family Pre-authorisation required R19 100 per family Pre-authorisation required Managed Care protocols apply
Managed Care protocols apply
PALLIATIVE CARE ( CANCER ONLY )
Unlimited , subject to using the Designated Service Provider
Managed Care protocols apply
Includes hospice / private nursing , home oxygen , pain management , psychologist and social worker support
Unlimited , subject to using the Designated Service Provider
Managed Care protocols apply
Includes hospice / private nursing , home oxygen , pain management , psychologist and social worker support
CATARACT SURGERY Avoid a R6 780 co-payment by using the Designated Service Provider Avoid a R6 780 co-payment by using the Designated Service Provider
DENTISTRY PMB only PMB only
CANCER TREATMENT ( ALSO SEE CARE PROGRAMMES PAGE 9 )
Unlimited for PMBs Pre-authorisation required Unlimited for PMBs Pre-authorisation required
Avoid a 30 % co-payment by using a Designated Service Provider Avoid a 30 % co-payment by using a Designated Service Provider
CANCER MEDICINE |
Subject to Medicine Price List and preferred product list |
Avoid a 20 % co-payment by using a Designated Service Provider |
Subject to Medicine Price List and preferred product list |
Avoid a 20 % co-payment by using a Designated Service Provider |
ORGAN TRANSPLANTS
KIDNEY DIALYSIS
PMB only Pre-authorisation required PMB only Pre-authorisation required Avoid a 30 % co-payment by using a Designated Service Provider
Avoid a 30 % co-payment by using a Designated Service Provider PMB only Pre-authorisation required PMB only Pre-authorisation required Avoid a 30 % co-payment by using a Designated Service Provider
Avoid a 30 % co-payment by using a Designated Service Provider
HIV / AIDS ( ALSO SEE CARE PROGRAMMES PAGE 10 ) |
Unlimited , if you register on the HIV / AIDS programme |
Avoid a 30 % co-payment by obtaining your chronic medicine from the Designated Service Provider |
Unlimited , if you register on the HIV / AIDS programme |
Avoid a 30 % co-payment by obtaining your chronic medicine from the Designated Service Provider |
DAY SURGERY PROCEDURES ( APPLIES TO SELECTED PROCEDURES )
Avoid a R12 050 co-payment by using a network day hospital Avoid a R12 050 co-payment by using a network day hospital
PROCEDURE CO-PAYMENTS ( SUBJECT TO PRE-AUTHORISATION )
SURGICAL PROCEDURES THAT ARE NOT COVERED
R2 890 co-payment ( Applies in addition to non-network hospital co-payment ) 1 . Arthroscopy ( when done as part of a surgical procedure ) 2 . Laparoscopic Hysterectomy Back and neck surgery Correction of Hallux Valgus Varicose vein surgery Non-cancerous breast conditions Nail disorders Skin disorders , including benign growths and lipomas Healthcare services for which admission to hospital is not necessary
Joint replacement surgery Functional nasal surgery Oesophageal reflux and hernia repair surgery Gastroscopies , colonoscopies and all other endoscopies Knee and shoulder surgery In-hospital dental surgery
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
12 BONSTART & BONSTART PLUS 2024 IN-HOSPITAL BENEFITS