GP consultations
(including virtual care consultations)
Paid from available GP & specialist benefit sublimit.
2 Additional network GP consultations per family when the GP & specialist consultations sublimit is reached
Specialist consultations
2 Additional network specialist consultations
X-rays and ultrasounds
Paid from available X-rays and blood tests benefit sublimit
Blood tests
Paid from available X-rays and blood tests benefit sublimit
Acute medicine
(20% co-payment for non-DSP/non-formulary use)
Paid from available acute and over-the-counter medicine benefit sublimit
Over-the-counter medicine
(20% co-payment for non-DSP/non-formulary use)
Over-the-counter medicine is limited to: R930 per beneficiary, R2 910 per family
Allied medical professionals
(such as dietician, speech and occupational therapist)
Paid from available auxiliary services benefit sublimit
Physiotherapy, podiatry and biokinetics
Paid from available auxiliary services benefit sublimit
General medical appliances
Subject to the available overall day-to-day limit. R8 890 per family for Stoma Care and CPAP machines.
Note: CPAP machines subject to Managed Care protocols
Emergency room benefit
(for emergencies only)
2 emergency consultations per family at a casualty ward or emergency room facility of a hospital. 2 emergency consultations at a casualty ward or emergency room facility of a hospital for children under the age of 6. If it is not classified as an emergency, it will be paid from available GP & specialist day-to-day benefit
Insulin pump or continuous glucose monitor & consumables
(limited to one device per type 1 diabetic for beneficiaries younger than 18)
1 insulin pump: R65 000 per family every 5years
1 continuous glucose monitor: R28 000 per family every year
Consumables limited to R93 000 per family
Blood pressure monitor
(subject to registration of chronic condition – hypertension)
Subject to the general medical appliances benefit R1 250 per family every 2 years
Audiology
(hearing aids, consultations and tests)
R9 460 per device (maximum two devices per family), once every 3 years (based on the date of your previous claim). All tests and consultations limited to the Hearing Loss Management Programme and use of a network provider
Optometry
(once every 2 years)
Paid from Risk
Basic dentistry
(Managed Care protocols apply)
Covered at the Bonitas Dental Tariff, subject to the Bonitas Dental Management Programme
Specialised dentistry
(Managed Care protocols apply)
Covered at the Bonitas Dental Tariff
Chronic medicine
(30% co-payment for non-DSP/non-formulary use)
45 chronic conditions: R13 030 per beneficiary, R26 150 per family, unlimited for PMB, subject to use of Bonitas Pharmacy Network and formulary