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Choosing a Medical Aid in South Africa


 

  

  

4 Benefit Groups for Bonitas Medical Aid  

In 2012 Bonitas medical aid has been in business for 30 years and is the second largest open medical scheme in South Africa.

Bonitas medical aidMost of the times the medical aid schemes are so complicated that it is difficult to understand what the features and benefits of each plan are. Bonitas has taken into consideration that it is potential members who are looking for the right plan that read the information on the website. They describe the benefits in an easy manner for you to understand, so that you can make an informative choice.

There are 4 major groups of benefits.

Major Medical Benefit

Major Medical Benefit covers hospital expenses and major medical treatments. You can go to any hospital. However, hospital expenses are covered totally when you are admitted to a hospital that Bonitas have negotiated certain fees with. Before you are admitted for the specific operation or procedure you need to receive authorization from Hospital Benefit Management to ensure what costs will be covered by the plan. The exception is emergency situations, when no prior authorization is required.

The comprehensive plan pays out up to 300% above the medical scheme tariff. The BonsSave and BonEssential plans pay out the full medical aid tariff.

Chronic Benefit

Chronic Benefit covers the medicines required for people with chronic conditions such as high blood pressure, diabetes or arthritis. This medication is needed continuously, often for a life time. The coverage of chronic medications is subject to authorization beforehand by Chronic Medicine Management.

Depending on the specific plan, 26 to 53 chronic diseases are covered. If your plan is BonSaveorBonEssential, then you have prescribed pharmacies and service providers that you must go to. 

Out of Hospital Benefit

Out of Hospital Benefit covers medical costs when not admitted to a hospital, in other words the day-to-day medical treatment. The Bonita medical schemes don’t cover all these expenses and a top-up plan is required, that differs with each type of plan. The different plans have different requirements:

·  BonEssential and BonSaverequire hospital plans in addition to the Out of Hospital Benefit to ensure you are covered completely.

·  Standard and Primary limits you to going to a general practitioner whose fee is not more than the accepted tariff of Bonitas.

·  BonComprehensive requires that you add a savings account in the form of a top-up-plan. You need to manage the account yourself.

Supplementary Benefit

Supplementary Benefit includes additional benefits when costs occur with medical treatment in hospital or out of hospitals. It is paid from the Overall Annual Limit and has certain requirements and limits. Included but not restricted to, are:

·  Appliances for example, hearing aids, wheelchair, oxygen and stomach products

· Cochlear implants for hearing challenges

· Emergency transport medical purposes with Netcare

· Endoscopies in doctor’s rooms

· Immune deficiency related to HIV infection

· Maternity care

·  Mental Health

· Specialized radiology (out of hospital)

 

Once again it is suggested to get quotes from the different medical aids you are considering. Bonitas medical aid website allows you to ask for quotes. © Medical Aid Plan