2026 Rules Active
2026 Validated
Child Capping with Sports Physiotherapy Coverage
Actuarial Objective
For active families with children needing 4 physiotherapy consultations per beneficiary for sport-related injuries
Running Actuarial Simulation...
More Plan Options
Save R765 pm
Bonitas
BonCore
Strategy: BonCore Disaster Cover Single
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Momentum Medical Scheme
Custom Option
Strategy: Custom Associated Hospital (Penalty avoidance)
Key Terms for this Strategy
- Network Restriction
- You must use hospitals and doctors listed in the scheme's specific network. Voluntary use of non-network providers will result in a heavy co-payment.
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries (like hip/knee replacements) that are not emergencies.
People Also Ask
Are joint replacements covered?
No, joint replacement surgery is listed under 'Surgical Procedures That Are Not Covered' and is excluded.
Can I go to any private hospital?
No, you must use a hospital on the applicable network. Using a non-network hospital incurs a R12,680 co-payment.
Is there a co-payment for admission at a network hospital?
Yes, there is a R1,240 co-payment per admission at a network hospital, except for PMB emergencies.
Are gastroscopies and colonoscopies covered?
No, gastroscopies, colonoscopies, and all other endoscopies are explicitly excluded from cover.
Do I need a referral to see a specialist?
Yes, you must get a referral from your network GP. Consultations are limited to 2 visits per family.
Is there a limit for chronic depression medication?
Yes, depression is covered as an additional condition, but medication is limited to R165 per beneficiary per month.
Does the plan cover MRI scans?
Yes, but there is a R14,090 family limit and a R2,800 co-payment per scan event, unless it is a PMB.
Are maternity scans covered?
Yes, BonStart Plus covers two 2D ultrasound scans during pregnancy.
How many GP visits do I get?
You get unlimited network GP consultations, but authorisation is required after the 10th visit.
What is the penalty for using a non-network day hospital?
If you do not use a network day hospital for selected procedures, you will be liable for a R12,680 co-payment.