Bonitas 2012 Products

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Products 2012
 
Bonitas Benefit Structure and Options
 
Nothing can be more important than the health and wellbeing of you and your family. Even if you're fit and healthy, an accident can happen at any time, so being covered for quality healthcare isn't a luxury, it's an imperative. Moreover, in this day and age of rising prices, the one thing that sets Bonitas apart is affordability. Therefore the following Bonitas plans are all designed to fit with your specific needs whilst still providing quality healthcare at affordable prices.
 
We have categorised our benefits into four main categories illustrated in the diagram on the right. When choosing 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 Benefit
Covers medicine for conditions that require medication on an ongoing basis

 
 
 

Supplementary Benefit
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 Bonitos and the major hospital groups. Hospital admission is subject to pre-authorisation by Hospital Benefit Management, except in the case of emergencies.
 
Products 2012 BonComprehensive BonEssential BonSave Standard Primary BonCap
Overall Annual Limit
Unlimited
Unlimited
Unlimited
Unlimited
R1 000 000 per family per annum R500 000 per family per annum
Reimbursement Rate
300% Bonitas Rate
100% Bonitas rate
150% Bonitas Rate
100% Bonitas Rate
100% Bonitas Rate 100% Bonitas Rate
Provider
Any hospital
Any hospital
Any hospital
Any hospital
Any hospital Prime Cure hospital network
 
Chronic Benefits
Chronic Benefits covers medicine for conditions that require medication on an ongoing basis. Subject to pre-authorisation by Chronic Medicine Management.
 
BonComprehensive BonEssential BonSave Standard Primary BonCap
R10 000 per beneficiary
R20 000 per family
(53 conditions)
Prescribed Minimum
Benefits only at
Designated Service
Provider (26 conditions)
Prescribed Minimum
Benefits only at Designated
Service Provider
(26 conditions)
R6 900 per beneficiary
R 13 800 per family
(42 conditions)

Prescribed Minimum
Benefits only at
Designated Service
Provider (26 conditions)

Prescribed Minimum
Benefits only at
Designated Service Provider
(26 conditions)
Comprehensive
Formulary in benefit.
Restrictive Formulary
when benefits are
exceeded for PMB's
Restrictive Formulary
Restrictive Formulary
Comprehensive
Formulary in benefit.
Restrictive Formulary
when benefits are
exceeded for PMB's
Restrictive Formulary Prime Cure Medicine
Formulary
Any Pharmacy or Dispensing GP
Pharmacy Direct
Pharmacy Direct
Any Pharmacy or
Dispensing GP up to
limit. PMB's unlimited at
DSP thereafter
Pharmacy Direct Prime Cure Network Pharmacy
 
Out of Hospital Benefits
Out of hospital benefits cover day to day medical expenses incurred out of hospital.
 
New Generation Options Traditional Options Low Cost Capitation Option
BonComprehensive BonEssential BonSave Standard Primary BonCap
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 contracted GP 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. Out of hospital expenses are managed without financial limits by the Prime Cure GP.
 
Reimbursement rate of heallhcare practitioners in hospital e.g. medical specialists
* Unlimited PMB cover