OUT-OF-HOSPITAL BENEFITS
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 6 for more information .
VIRTUAL CARE GP AND NURSE CONSULTATIONS
BONSTART
Unlimited network GP and Nurse Virtual Care consultations
BONSTART PLUS
Unlimited network GP and Nurse Virtual Care consultations
GP CONSULTATIONS
Unlimited GP consultations Authorisation required after 6th visit Unlimited GP consultations Authorisation required after 10th visit
|
R120 co-payment per visit |
2 non-network GP consultations for emergencies per family |
R65 co-payment per visit |
2 non-network GP consultations for emergencies per family |
EMERGENCY ROOM BENEFIT ( NEW ) ( FOR EMERGENCIES ONLY ) |
2 emergency consultations per family at a casualty ward or emergency room facility of a hospital |
Benefit limited to emergencies only |
2 emergency consultations per family at a casualty ward or emergency room facility of a hospital |
Benefit limited to emergencies only |
GP-REFERRED ACUTE MEDICINE , X-RAYS AND BLOOD TESTS
Limited to R1 690 per family
Subject to the radiology and pathology formulary
For acute medicine :
• A 20 % co-payment will apply per script
• Avoid a 40 % co-payment by using a Bonitas Pharmacy Network
• Subject to medicine formulary use
Limited to R3 160 per family
Subject to the radiology and pathology formulary
For acute medicine :
• A 20 % co-payment will apply per script
• Avoid a 40 % co-payment by using a Bonitas Pharmacy Network
• Subject to medicine formulary use
OVER-THE-COUNTER MEDICINE ( INCLUDES A LIST OF SPECIFIED SUPPLEMENTS )
Limited to R105 per event Maximum of R520 per family , per year Limited to R165 per event Maximum of R785 per family , per year
Avoid a 20 % co-payment by using medicine that is on the formulary and completing your wellness screening
Avoid a 20 % co-payment by using the Bonitas Pharmacy Network
Avoid a 20 % co-payment by using medicine that is on the formulary and completing your wellness screening
Avoid a 20 % co-payment by using the Bonitas Pharmacy Network
SPECIALIST CONSULTATIONS ( YOU MUST GET A GP REFERRAL ) |
Limited to 1 visit per family up to R1 250 |
Including all acute medicine , basic radiology , specialised radiology and pathology prescribed by the specialist |
Limited to 2 visits per family up to R2 260 |
Including all acute medicine , basic radiology , specialised radiology and pathology prescribed by the specialist |
R250 co-payment per visit Subject to GP referral R120 co-payment per visit Subject to GP referral
OPTOMETRY
1 eye test per beneficiary at a network provider
Limited to R380 at a non-network provider
R110 co-payment
1 eye test per beneficiary at a network provider
Limited to R380 at a non-network provider
R110 co-payment
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 BONSTART & BONSTART PLUS 2024 OUT-OF-HOSPITAL BENEFITS