BonSave

New Generation PlanFrom R1 558 p/m

If you’re fit and flexible, you might want the same from your medical plan. With BonSave you manage your day-to-day expenses with the savings account. It’s all geared to help you better manage your health.

Summary

  • Major Medical Benefits
    This benefit includes all hospital admissions, oncology treatments and renal dialysis, however, these do require pre-authorisation by Hospital Benefit Management except in case of emergencies.
  • Chronic Medicine Benefits
    Covers medication for the 26 Prescribed Minimum Benefit chronic conditions that requires medication on an ongoing basis.
  • Out of Hospital Benefits
    Covers day to day expenses for example: GP consultations, optometry, basic dentistry and acute medication.
  • Supplementary Benefits
    Additional benefits, medical expenses incurred in or out of hospital. All the following benefits are paid from the Overall Annual Limit and are subject to benefit limits.

What will it cost?

  Risk Savings Total
  • Contributions are calculated for the first three child dependants only.
  • Prescribed Minimum Benefits are provided on all options in accordance with the Medical Schemes Act and Regulations.
  • Subject to pre-authorisation
  • All benefits are per annum, unless otherwise stated
Principal Member R1 293 R 265 R1 558
Adult Dependant R1 002 R 205 R1 207
Child Dependant R 388 R 80 R 468

Major Medical Benefits

This benefit includes all hospital admissions, oncology treatments and renal dialysis, however, these do require pre-authorisation by Hospital Benefit Management except in case of emergencies.

Overall Annual Limit:
Unlimited
Reimbursement Rate:
150% Bonitas Rate
Hospital Network:
N/A
Benefits payable at 150% of the Bonitas Rate Rate
1All members enrolled in clinical trials should inform the scheme
Overall Annual Limit (overall annual limit) Unlimited
GP & Specialist Consultations Unlimited
Pathology Unlimited
Radiology (Specialised & General) Unlimited
Paramedical Services (Allied Medical, Professions) Unlimited
Oncology1 R264 500 per family
Organ Transplants Unlimited
Chronic Renal Dialysis PMB’s, covered as per state protocol
Maxillo Facial Surgery Unlimited, excluding orthognathic surgery
Medication to take out (TTO) R290 per beneficiary, per admission
Physical Rehabilitation R38 000 per family
Alternatives to hospitalisation R12 700 per family

Deductions

R1 000 deductible
  1. Colonoscopy
  2. Conservative Back Treatment
  3. Cystoscopy
  4. Facet Joint Injections
  5. Flexible Sigmoidoscopy
  6. Functional Nasal Surgery
  7. Gastroscopy
  8. Hysteroscopy (but not endometrial ablation)
  9. Myringotomy
  10. Tonsillectomy and Adenoidectomy (except PMB’s)
  11. Umbilical Hernia Repair
  12. Varicose Vein Surgery
R2 500 deductible
  1. Arthroscopy
  2. Diagnostic Laparoscopy
  3. Hysterectomy (except cancer and PMB’s)
  4. Percutaneous Radiofrequency Ablations
  5. Percutaneous Rhizotomies
  6. Laparoscopic Appendectomy
  7. Laparoscopic Nephrectomy
R5 000 deductible
  1. Back Surgery including spinal fusion
  2. Nissen Fundoplication (Reflux Surgery)
  3. Joint replacements e.g. Hip & Knee replacements (except PMB’s)
  4. Laparoscopic Pyeloplasty
  5. Laparoscopic Radical Prostatectomy

Chronic Medicine Benefits

Covers medication for the 26 Prescribed Minimum Benefit chronic conditions that requires medication on an ongoing basis.

Limit:
A specified list of 26 conditions are covered
Formulary list:
Restrictive formularies
Provider:
Pharmacy Direct is the DSP for the delivery of medication. 40% co-payment will apply at a non-Designated Service Provider.
Chronic Medicine Management
To apply for chronic medicine authorisation the member, doctor or pharmacist can call the chronic medicine call centre on 0860 100 608 or email cmm@medscheme.co.za and request an application form.

A specified list of 26 conditions is provided.

  1. Addison’s Disease
  2. Asthma
  3. Bipolar Mood Disorder
  4. Bronchiectasis
  5. Cardiac Failure
  6. Cardiomyopathy
  7. Chronic Renal Disease
  8. Chronic Obstructive Pulmonary Disease
  9. Coronary Artery Disease
  10. Crohn’s Disease
  11. Diabetes Insipidus
  12. Diabetes Mellitus Type 1
  13. Diabetes Mellitus Type 2
  14. Dysrhythmias
  15. Epilepsy
  16. Glaucoma
  17. Haemophilia
  18. Hyperlipidaemia
  19. Hypertension
  20. Hypothyroidism
  21. Multiple Sclerosis
  22. Parkinson’s Disease
  23. Rheumatoid Arthritis
  24. Schizophrenia
  25. Systemic Lupus Erythematosus
  26. Ulcerative Colitis

Out of Hospital Benefits

Covers day to day expenses from the savings:

  • GP consultations
  • Optometry
  • Basic dentistry
  • Specialist consultations
  • Acute medication
  • Radiology
  • Pathology
  • Paramedical

Bonitas specialist network is the scheme designated service provider for the provision of PMB’s. No co-payments will apply at a specialist Network Provider, while in benefit.

Additional threshold benefit for GP consultations once savings is exhausted

Savings Per Month Per Annum
Principal Member R 265 R3 180
Adult Dependant R 205 R2 460
Child Dependant R 80 R 960
Day to Day Benefits paid from savings
GP Consultations Subject to savings. Once allocated savings for the year have been exhausted, 3 consultations per beneficiary, up to a maximum of 6 consultations per family will be paid from risk. Unused consultations will not be carried over to the following year.
Specialist Consultations Subject to savings
Acute Medication & Pharmacy Advised Therapy Subject to savings
General Radiology Subject to savings
Pathology Subject to savings
Optometry Subject to savings
Paramedical Services (Allied Medical, Professions) Subject to savings
Basic Dentistry Covered according to DENIS clinical protocals and Bonitas Dental Tariff (BDT)
Advanced Dentistry No benefit

Supplementary Benefits

Additional benefits, medical expenses incurred in or out of hospital. All the following benefits are paid from the Overall Annual Limit and are subject to benefit limits. These include:

  • Maternity Care* per event
  • Immune deficiency related* to HIV infection
  • Mental Health Benefits*
Supplementary Benefits
Maternity Care* per event (ante- and postnatal) Unlimited hospitalisation. Subject to pre-authorisation. 6 ante-natal consultations, 2 x 2D scans and 4 post-natal consultations with midwife. R950 for ante-natal classes.
Immune deficiency related to HIV infection* R24 800 per beneficiary. Subject to Aid for AIDS (AfA) registration. Clinical protocols applies.
Mental Health Benefits* R24 800 per family, subject to pre-authorisation and includes a sub-limit of R12 150 for consultations in & out of hospital.
Specialised Radiology* (out of hospital) R17 000 per family, subject to pre-authorisation
Emergency Medical Transportation Subject to ER24 authorisation.
Endoscopies* in practitioners’ rooms Unlimited, subject to pre-authorisation.
Prostheses Internal and External* PMB’s only
HIV test and Flu vaccine 1 each per beneficiary per annum
Infant Paediatric Benefit (out of hospital paid from risk) 2 consultations before the age of 1 year. 1 consultation p.b.p.a. between the ages of 1 and 2 years.
Childhood illness benefit. Consultations paid from risk 1 GP consultation p.b.p.a between the ages of 2 and 12 years
Appliances
General appliances R5 600 per family
Wheelchairs & large orthopaedic appliances Included in the general appliance limit
Stoma products & CPAP* machines May exceed general appliance limit by R5 000
Oxygen: Home ventilation* Unlimited, subject to pre-authorisation by Hospital Management