You will face a 30% co-payment of the hospital bill if you use a hospital that is not on the BonSave network. The plan uses a list of specific private hospitals, and this penalty applies unless it's a PMB emergency. Network specialists are covered in full at the Bonitas Rate, while non-network specialists are paid at 100% of the Bonitas Rate.

Yes, but with strict limits. Depression medication is covered up to R165 per beneficiary per month (total R1,980 annually). This is listed as the 28th chronic condition covered. You must use Pharmacy Direct (the Designated Service Provider) to get your medicine. If you don't use Pharmacy Direct or choose medicine not on the formulary, you will pay a 30% co-payment.

Joint replacement surgery is excluded from the internal prosthesis benefit except for PMB conditions only. The internal prosthesis limit is R41,070 per family, but this explicitly states 'no cover for joint replacement except for PMB'. If your joint replacement qualifies as a PMB, it will be covered subject to Managed Care protocols and the use of network hospitals to avoid the 30% co-payment.

BonSave covers unlimited cancer treatment for PMB conditions at a DSP. However, non-PMB cancer treatment has a limit of R224,100 per family. Once this limit is reached, non-PMB treatment is paid at 80% at a DSP and has no cover at a non-DSP. You must register on the Oncology Management Programme. Cancer medicine requires a 20% co-payment if you don't use a DSP. Brachytherapy has a sub-limit of R63,110 per beneficiary.

Yes. Colonoscopies and gastroscopies both have a R2,020 co-payment per procedure. This applies to in-hospital scopes. Cystoscopies, flexible sigmoidoscopies, and hysteroscopies also have the same R2,020 co-payment. These co-payments do not apply to PMB conditions.

Yes. The plan charges a R1,860 co-payment per MRI or CT scan, even though the annual family limit is R30,430 (combined in and out-of-hospital). This co-pay does not apply if the scan is confirmed as a Prescribed Minimum Benefit (PMB). The scan limit and co-pay apply to both in-hospital and out-of-hospital scans.

Yes. The Emergency Room Benefit covers 2 emergency consultations per family per year at a casualty ward or emergency room facility of a hospital. An additional 2 emergency consultations are available for children under the age of 6. The benefit is strictly limited to emergencies only. If your visit is not classified as an emergency, it will be paid from available savings.

The Benefit Booster is an extra R5,000 per family per year for out-of-hospital expenses like GP visits, over-the-counter medicine, X-rays, and blood tests. To activate it, you must complete an online mental health assessment and a wellness screening at a Bonitas wellness day or participating pharmacy. Once activated, out-of-hospital claims pay from this amount first, helping your savings last longer.

Your Medical Savings Account (MSA) is R12,144 per year for the main member (R1,012/month). Adult dependants get R9,180/year (R765/month) and child dependants get R3,636/year (R303/month). All out-of-hospital expenses like GP visits, specialist consultations, medicine, blood tests, X-rays, and dentistry are paid from your available savings. If you deplete your savings, you still get 2 additional GP consultations per family (limited to 1 per beneficiary).

Cataract surgery is covered, but you can avoid a R8,400 co-payment by using the Designated Service Provider (DSP). If you choose a non-DSP provider for cataract surgery, the R8,400 co-payment applies per procedure. Pre-authorisation is required for all procedures.