Bonitas Medical Fund Product Range

Products 2011

Bonitas Benefit Structure and Options

In these times, affordable, quality health cover has become something of a necessity - rather than an option. Which is why our six solutions ensure you're well looked after. So whatever your particular need is, we're serious enough about it to have an answer in: BonComprehensive, BonEssential, BonSave, Standard, Primary and BonCap. Just say the word.

We have categorized our benefits into four main categories illustrated in the diagram on the right. When chosing your option, we would like you to consider your healthcare needs in respect of the three main benefit categories listed below. Once you have made your selection we encourage you to look at the option you have selected in more detail, considering also the supplementary benefits provided.

Major Medical Covers medical expenses in hospital and major medical events

Chronic Medication
Covers medicine for conditions that require medication on an ongoing basis

Supplementary Additional benefits, medical expenses incurred in or out of hospital

Out of Hospital Covers out of hospital medical expenses

Major Medical Benefits

Major medical benefits cover medical expenses in hospital and major medical events. Hospital accounts are covered in full as per the negotiated rates between Bonitas and the major hospital groups. Hospital admission is subject to pre-authorisation by Hospital Management, except in the case of emergencies.

Products 2011	BonComprehensive	BonEssential	BonSave	Standard	Primary
Limit	Unlimited	Unlimited	Unlimited	Unlimited	R750 000 per family per annum
Reimbursement Rate*	300% Bonitas Rate	100% Bonitas rate	150% Bonitas Rate	100% Bonitas Rate	100% Bonitas Rate
Provider	Any hospital	Any hospital	Any hospital	Any hospital	Any hospital

Chronic Benefits

Chronic benefits cover medicine for conditions that require medication on an ongoing basis. Subject to pre-authorisation by Chronic Medicine Management.

BonComprehensive	BonEssential	BonSave	Standard	Primary
R10 000 per beneficiary R20 000 per family (54 conditions) Comprehensive Formulary	Prescribed Minimum Benefits only at Designated Service Provider (26 conditions) Restrictive Formulary	Prescribed Minimum Benefits only at Designated Service Provider (26 conditions) Restrictive Formulary	R6 900 per beneficiary R13 800 per family (42 conditions) Comprehensive Formulary in benefit. Restrictive Formulary when benefits are exceeded for PMB's	Prescribed Minimum Benefits only at Designated Service Provider (26 conditions) Restrictive Formulary
Any Pharmacy or Dispensing GP	Pharmacy Direct	Pharmacy Direct	Any Pharmacy or Dispensing GP limit PMB's unlimited at DSP thereafter	Pharmacy Direct

Out of Hospital Benefits

Out of hospital benefits cover day to day medical expenses incurred out of hospital.

New Generation Options			Traditional Options
BonComprehensive	BonEssential	BonSave	Standard	Primary
A savings account enables members to self-insure and manage their own out of hospital medical expenses. Unspent savings are carried forward with interest. An insured threshold benefit provides additional peace of mind for high out of hospital expenses.	A hospital plan and cover for PMB conditions.	A savings account enables members to self-insure and manage their own out of hospital medical expenses. Unspent savings are carried forward with interest.	Out of hospital care is coordinated through your general practitioner (GP). Visiting a GP contracted on the Bonitas GP Network ensures that you will not be charged anything in excess of the Bonitas Tariff. Acute medication, radiology and pathology etc. prescribed by your doctor is available from your Day to Day Benefit. Specialist consultations are also payable from this benefit if referred by your GP.

* Reimbursement rate of healthcare practitioners in hospital e.g. medical specialists

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