No, joint replacement surgery is explicitly listed as an exclusion on this plan. Strategy reference: age-2026.

No, you must use a BonCap Network GP. One out-of-network visit is allowed per beneficiary with a 30% co-payment unless it is a PMB. Strategy reference: age-2026.

Yes, you must obtain a referral from a BonCap Network GP to see a specialist, and pre-authorisation is required. Strategy reference: age-2026.

Yes, there is a R1,230 co-payment per scan event, unless it is for a Prescribed Minimum Benefit (PMB) condition. Strategy reference: age-2026.

You will be liable for a 30% co-payment on the hospital account, except in cases of emergency. Strategy reference: age-2026.

Yes, GP-referred acute medicine is limited to R2,390 for a single member, increasing with family size. Strategy reference: age-2026.

Yes, Depression is covered as the 28th chronic condition, with medication cover limited to R165 per beneficiary per month. Strategy reference: age-2026.

You are covered for 2 emergency consultations per family at a casualty ward. If the visit is not classified as an emergency, it will be paid from your day-to-day GP benefit. Strategy reference: age-2026.

Yes, contraceptives are covered up to R1,330 per family, but you must use a Designated Service Provider (DSP) pharmacy to avoid a 40% co-payment. Strategy reference: age-2026.

If you use a network day hospital for listed procedures (like gastroscopies), there is no co-payment. Using an acute hospital will incur a 30% co-payment. Strategy reference: age-2026.