2016 Bonitas Product Comparison
Transcription
2016 Bonitas Product Comparison
2016 BONITAS BonComprehensive 2016 BONITAS BonClassic 2016 BONITAS Standard 2016 BONITAS Standard Select 2016 BONITAS BonSave 2016 BONITAS Primary 2016 BONITAS BonFit 2016 BONITAS BonEssential Main Member: R4 696 Adult Dependant: R4 428 Child Dependant: R956 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R3 260 Adult Dependant: R2 799 Child Dependant: R805 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R2 683 Adult Dependant: R2 321 Child Dependant: R784 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R2 321 Adult Dependant: R2 007 Child Dependant: R678 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R1 908 Adult Dependant: R1 478 Child Dependant: R572 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R1 719 Adult Dependant: R1 345 Child Dependant: R548 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R1 598 Adult Dependant: R1 238 Child Dependant: R479 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Main Member: R1 316 Adult Dependant: R1 007 Child Dependant: R386 (Your Fourth and Subsequent Children Will Be Covered Free of Charge) Unlimited, Paid at 300% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited at Network Hospitals, Paid at 100% Bonitas Rates Unlimited, Paid at 150% Bonitas Rate Unlimited, Paid at 100% Bonitas Rates Unlimited at Network Hospitals, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Principal: R10 632 Adult: R10 020 Child: R2 172 "Annual Savings (14%) Principal: R5 532 Annual Savings (4%) allocated to use prior to the Risk Benefits for Acute Medication; GP and Specialist Consultations; Radiology and Pathology. Annual Savings: Principal: R1 212 Adult: R1 056 Child: R360 Annual Savings (4%) allocated to use prior to the Risk Benefits for Acute Medication; GP and Specialist Consultations; Radiology and Pathology. Annual Savings: Principal: R1 056 Adult: R900 Child: R300 Annual Savings (16%) Principal: R3 672 Adult: R2 844 Child: R1 104 N/A Annual Savings (15%) Principal: R2 880 Adult: R2 232 Child: R864 N/A N/A N/A Limited to: M: R4 020 M + 1: R6 140 M + 2: R6 590 M + 3: R7 110 M + 4: R7 600 Limited to: M: R4 020 M + 1: R6 140 M + 2: R6 590 M + 3: R7 110 M + 4: R7 600 N/A Limited to: M: R1 800 M + 1: R3 250 M + 2: R3 800 M + 3: R4 100 M + 4: R4 450 N/A N/A SELF PAYMENT GAP (SPG) Principal: R3 428 Adult: R2 840 Child: R1 308 N/A N/A N/A N/A N/A N/A N/A THRESHOLD LEVEL Principal: R14 060 Adult: R12 860 Child: R3 480 N/A N/A N/A N/A N/A N/A N/A MONTHLY CONTRIBUTIONS OVERALL ANNUAL LIMIT (OAL) MEDICAL SAVINGS ACCOUNT (MSA) DAY-TO-DAY BENEFIT ABOVE THRESHOLD BENEFIT (ATB) CO-PAYMENTS FOR PROCEDURES Unlimited N/A N/A N/A N/A N/A N/A N/A None None None None Subject to Deductibles for Certain Procedures Ranging from R1050 to R2650 and R5250 Subject to Deductibles for Certain Procedures Ranging from R1050 to R2650 and R5250 Subject to Deductibles for Certain Procedures Ranging from R1050 to R2650 and R5250 Subject to Deductibles for Certain Procedures Ranging from R1050 to R2650 and R5250 Limited to R14 200 pfpa Limited to R14 200 pfpa Limited to R14 200 pfpa Limited to R14 200 pfpa Limited to R14 200 pfpa Limited to R14 200 pfpa Limited to R14 200 pfpa HOSPITALISATION ALTERNATIVES TO HOSPITALISATION PHYSICAL REHABILITATION GP CONSULTATIONS SPECIALIST CONSULTATIONS GENERAL RADIOLOGY Limited to R14 200 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Limited to R42 500 pfpa Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network GP's: Paid at 130% Bonitas Rates. Non-Network GP's: Paid at 100% Bonitas Rates Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Unlimited, Network Specialists: Paid at 130% Bonitas Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Rates. Non-Network Specialists: Paid at 100% Bonitas Rates Bonitas Rates Bonitas Rates Bonitas Rates Bonitas Rates Bonitas Rates Bonitas Rates Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Subject to Pre-Authorisation Limited to R24 850 pfpa In and Out of Hospital Unlimited In Hospital, Subject to Pre-Authorisation Unlimited In Hospital, Subject to Pre-Authorisation Unlimited In Hospital, Paid at 100% Bonitas Rates. Subject to Pre-Authorisation R11 150 pfpa (In & Out of Hospital) Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation PATHOLOGY Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates ALLIED PROFESSIONALS Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates SPECIALISED PROCEDURES Cochlear Implants: Limited to R250 000 pfpa. Internal Nerve Stimulators: Limited to R142 000 pfpa Cochlear Implants Limited to R250 000 pfpa Cochlear Implants: Limited to R250 000 pfpa. Internal Nerve Stimulators: Limited to R142 000 pfpa Cochlear Implants: Limited to R250 000 pfpa. Internal Nerve Stimulators: Limited to R142 000 pfpa N/A N/A N/A N/A PROSTHESES Internal Prostheses: Limited to R47 250 pfpa. External Prostheses: Limited to R47 250 pfpa Internal and External Prostheses: Limited to R46 800 pfpa Internal and External Prostheses: Limited to R37 900 pfpa Internal and External Prostheses: Limited to R37 900 pfpa. Hip and Knee Replacements Only at ICPS PMB's Only PMB's Only PMB's Only PMB's Only MATERNITY CONFINEMENT Unlimited Hospitalisation, Private Ward after Delivery Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Pre-Authorisation R40 200 pfpa. Up to R13 600 pfpa Can Be Used for Out Of Hospital Consultations Limited to R35 350 pfpa, Sub-limit of R13 600 pfpa for Consultations In and Out of Hospital Limited to R34 800 pfpa, Sub-Limit of R13 600 pfpa for Consultations In and Out of Hospital Limited to R34 800 pfpa, Sub-Limit of R13 600 pfpa for Consultations In and Out of Hospital Limited to R27 650 pfpa, Sub-Limit of R13 600 pfpa for Consultations In and Out of Hospital Limited to R13 550 pfpa, Sub-Limit of R8 200 pfpa for Consultations In and Out of Hospital Limited to R27 650 pfpa In Hospital Only Limited to R27 650 pfpa In Hospital Only R470 per Beneficiary per Admission R400 per Beneficiary per Admission R400 per Beneficiary per Admission R400 per Beneficiary per Admission R325 per Beneficiary per Admission R325 per Beneficiary per Admission R325 per Beneficiary per Admission R325 per Beneficiary per Admission Paid From Available Savings and/or Threshold Benefit Paid from Available Savings Subject to Available Savings and Day to Day Limit Subject to Available Savings and Day to Day Limit Subject to Available Savings Paid from Available Day to Day Benefit Paid From Available Savings No Benefit SPECIALISED RADIOLOGY: MRI & CT SCANS MENTAL HEALTH TAKE HOME MEDICATION CASUALTY AND EMERGENCY CONSULTATIONS EMERGENCY ASSISTANCE ONCOLOGY RENAL DIALYSIS ORGAN TRANSPLANTS ER24 ER24 ER24 ER24 ER24 ER24 ER24 ER24 Limited to R530 200 pfpa. Biological Drugs: Limited to R210 400 pfpa Limited to R351 900 pfpa. Biological Drugs: Limited to R105 200 pfpa (10% co-payment applies) Limited to R295 400 pfpa Limited to R295 400 pfpa Limited to R295 400 pfpa Limited to R142 000 pfpa Limited to R295 400 pfpa Limited to R295 400 pfpa Unlimited Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates PMB's Only PMB's Only PMB's Only PMB's Only Unlimited Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited, Paid at 100% Bonitas Rates Unlimited PMB's Only Unlimited, Subject to Pre-Authorisation Unlimited, Subject to Managed Care Protocols Unlimited, Subject to Registration on Aid for AIDS (AfA) Programme Unlimited, Subject to Registration on Aid for AIDS (AfA) Programme R27 800 pbpa if Registered on Aid for AIDS (AfA) Programme R27 800 pbpa if Registered on Aid for AIDS (AfA) Programme R27 650 pbpa If Registered on Aid for AIDS (AfA) Programme R21 250 pbpa If Registered on Aid for AIDS (AfA) Programme. Limited to R27 650 pbpa If Registered on Aid for AIDS (AfA) Programme Limited to R27 650 pbpa If Registered on Aid for AIDS (AfA) Programme GP CONSULTATIONS Paid From Available Savings and/or Threshold Benefit Paid from Available Savings Paid from Available Savings Network GP: M: R1 700 M +1: R3 150 M + 2: R3 700 M + 3: R4 000 M + 4 +: R4 500 of Which only the Following Values Can be Used at a Non-Network GP: M: R560 M + 1: R1 050 M + 2: R1 200 M + 3: R1 350 M + 4 +: R1 550 Paid From Available Savings No Benefit SPECIALIST CONSULTATIONS Paid From Available Savings and/or Threshold Benefit Paid from Available Savings Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings Paid From Available Day to Day Benefit Paid From Available Savings No Benefit ACUTE MEDICATION Paid From Available Savings and/or Threshold Benefit Paid from Available Savings Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings Paid from available Day to Day Benefit. Over the Counter Medication: Sub-limit of R420 pbpa or R1 230 pfpa Paid From Available Savings No Benefit GENERAL RADIOLOGY Paid From Available Savings and/or Threshold Benefit Limited to R2 680 pbpa, and R4 130 pfpa Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings Paid From Available Day to Day Benefit Paid From Available Savings No Benefit Limited to R26 850 pfpa, Subject to Pre-Authorisation Limited to R24 850 pfpa In and Out of Hospital Limited to R22 400 pfpa Out of Hospital, Subject to Pre-Authorisation Limited to R22 400 pfpa Out of Hospital, Subject to Pre-Authorisation Limited to R20 000 pfpa. Subject to Pre-Authorisation R11 150 pfpa (In & Out of Hospital) Paid From Available Savings No Benefit Paid From Available Savings and/or Threshold Benefit Limited to R2 680 pbpa and R5 890 pfpa Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings Paid From Available Day to Day Benefit Paid From Available Savings No Benefit HIV/AIDS DAY-TO-DAY BENEFITS SPECIALISED RADIOLOGY: MRI & CT SCANS PATHOLOGY GP Consultations Paid from GP Benefit: GP Consultations Paid from GP Benefit: Network GP: Network GP: M: R3 580 M: R3 580 M + 1: R5 260 M M + 1: R5 260 M + 2: R5 790 + 2: R5 790 M + 3: R6 100 M + 3: R6 100 M + 4 +: R6 630 M + 4 +: R6 630 of Which only the Following Values Can be Used of Which only the Following Values Can be Used at a Non-Network GP: at a Non-Network GP: M: R1 160 M: R1 160 M + 1: R1 790 M + 1: R1 790 M + 2: R1 950 M + 2: R1 950 M + 3: R2 050 M + 3: R2 050 M + 4 +: R2 210 M + 4 +: R2 210 2016 BONITAS BonComprehensive 2016 BONITAS BonClassic 2016 BONITAS Standard 2016 BONITAS Standard Select 2016 BONITAS BonSave 2016 BONITAS Primary 2016 BONITAS BonFit 2016 BONITAS BonEssential Paid From Available Savings and/or Threshold Benefit M: R2 550 M + 1: R3 900 M + 2: R4 500 M + 3: R4 800 M + 4 +: R5 150 Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings, Then Covered From Day to Day Benefit Paid from Available Savings Paid From Available Day to Day Benefit Paid From Available Savings No Benefit General Appliances: R7 550 pfpa, Stoma Products and CPAP: May exceed annual General Limit by R5 300. Hearing Aids: Limited to R22 100 per family every 2 years (10% co-payment applies). Foot Orthotics: Limited to R3 900 pbpa (10% co-payment applies). General Appliances: Limited to R7 000 pfpa. Hearing Aids: Limited to R14 500 pf every 3 years(10% CoPayment Applies) . Foot Orthotics: Limited to R3 900 pbpa (10% Co-Payment Applies). CPAP Machines and Stoma Products: Included in General Appliances Limit General Appliances: R6 900 pfpa, Stoma Products and CPAP: May exceed annual General Limit by R5 600. Hearing Aids: Limited to R13 700 per family every 2 years (10% co-payment applies). Foot Orthotics: Limited to R3 900 pbpa (10% co-payment applies). General Appliances: R6 900 pfpa, Stoma Products and CPAP: May exceed annual General Limit by R5 600. Hearing Aids: Limited to R13 700 per family every 2 years (10% co-payment applies). Foot Orthotics: Limited to R3 900 pbpa (10% co-payment applies). General Appliances: Limited to R6 200 pfpa, Stoma Products and CPAP: May Exceed Annual General Limit by R5 600. Foot Orthotics: Limited to R3 900 pbpa (10% co-payment applies) General Appliances: Limited to R6 200 pfpa, Stoma Products and CPAP: May Exceed Annual General Limit by R5 600. Hearing Aids: Limited to R7 800 per Family Once every 2 years (10% co-payment applies). Foot Orthotics: Limited to R3 900 pbpa (10% co-payment applies) Paid From Available Savings No Benefit BASIC DENTISTRY Paid From Available Savings and/or Threshold Benefit Limited to R4 000 pfpa Subject to DENIS Clinical Protocols and Bonitas rate Subject to DENIS Clinical Protocols and Bonitas rate Subject to DENIS Clinical Protocols and Bonitas Rate Subject to DENIS Clinical Protocols and Bonitas Rate Paid From Available Savings No Benefit SPECIALISED DENTISTRY Paid From Available Savings and/or Threshold Benefit Limited to R4 800 pfpa Subject to DENIS Clinical Protocols and Bonitas rate Subject to DENIS Clinical Protocols and Bonitas rate No Benefit No Benefit No Benefit No Benefit OPTICAL LIMIT Limited to R2 740 pbpa, Paid From Available Savings and/or Threshold Benefit Limited to R5 060 pf Every 2 Years Limited to R5 270 pf Every 2 Years Limited to R5 270 pf Every 2 Years Paid from Available Savings Limited to R4 270 pf Every 2 Years Paid From Available Savings No Benefit MATERNITY PROGRAMME BENEFITS Consultations: 12 xAnte-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Ante-Natal Classes: Limited to R1 100 per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 12 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Ante-Natal Classes: Limited to R1 100 per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 12 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Ante-Natal Classes: Limited to 1 050 per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 12 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Ante-Natal Classes: Limited to 1 050 per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 6 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Ante-Natal Classes: Limited to 1 050 per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 6 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 6 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy Consultations: 6 x Ante-Natal Consultations. Scans: 2 x 2D Scans per Pregnancy. Post-Natal Consultations: 4 x Consultations With a Midwife. Tests: 1 x Amniocentesis per Pregnancy ALLIED PROFESSIONALS GENERAL MEDICAL APPLIANCES PREVENTATIVE CARE PREVENTATIVE CARE BENEFIT General Health: 1 HIV Test pbpa. Women's Health: 1 Mammogram every 2 years Between Ages 50 - 74 years, 1 Pap Smear every 3 years Between ages 21 - 65 years. Men's Health: PSA Test Approved for Men Aged 55 to 69 Considered to be at High Risk. Cardiac Health: 1 Full Lipogram every 5 years pb . Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75, 1 Bone Densitometry Screening Test for Females > 65 years. Children's Health: 1 TSH Test for Infants Below 1 month General Health: 1 HIV Test pbpa. Women's Health: 1 Mammogram every 2 years Between Ages 50 - 74 years, 1 Pap Smear every 3 years Between ages 21 - 65 years. Cardiac Health: 1 Full Lipogram every 5 years pb. Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75, 1 Bone Densitometry Screening Test for Females > 65 years. General Health: 1 HIV Test pbpa. Women's Health: 1 Mammogram every 2 years Between Ages 50 - 74 years, 1 Pap Smear every 3 years Between ages 21 - 65 years. Cardiac Health: 1 Full Lipogram every 5 years pb . Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75 General Health: 1 HIV Test pbpa. Women's Health: 1 Mammogram every 2 years Between Ages 50 - 74 years, 1 Pap Smear every 3 years Between ages 21 - 65 years. Cardiac Health: 1 Full Lipogram every 5 years pb. Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75, 1 Bone Densitometry Screening Test for Females > 65 years. General Health: 1 x HIV Test pbpa. Women's Health: 1 Pap Smear every 3 years Between ages 21 and 65 years. Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75 General Health: 1 x HIV Test pbpa. Women's Health: 1 Pap Smear every 3 years Between ages 21 and 65 years. Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75 General Health: 1 x HIV Test pbpa. Women's Health:1 Pap Smear every 3 years Between ages 21 and 65 years. Elderly Health: 1 Pneumococcal Vaccination above age 65 years & 1 Faecal Occult Blood Test pbpa Between ages 50 - 75 General Health: 1 HIV Test pbpa. Elderly Health: 1 Faecal Occult Blood Test pbpa Between ages 50 - 75 Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement Annual Wellness Check Provided. Must be Done by a Registered Provider and Includes, Blood Pressure Test, Glucose Test, Cholesterol Test, a BMI Test and a Waist to Hip Ratio Measurement IMMUNISATION PROCEDURES 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa 1 Flu Vaccine pbpa INFANT PAEDIATRIC BENEFIT 3 Paediatric Consultations per Child in 1st year and 2 Paediatric Consultations per Child for Children Ages 1-2 years. N/A 2 Consultations before the Age of 1, 2 Consultations between the ages of 1 and 2 years per beneficiary 2 Consultations before the Age of 1, 2 Consultations between the ages of 1 and 2 years per beneficiary 2 Consultations before the age of 1 pbpa, 1 Consultation between the ages of 1 and 2 years pbpa 1 Consultation before the age of 1 pbpa, 1 Consultation between the ages of 1 and 2 years pbpa 2 consultations before the age of 1 pbpa, 1 Consultation between the ages of 1 and 2 years pbpa N/A CHILDHOOD ILLNESS BENEFIT 2 GP Consultations pbpa For Children Ages 2-12 years. N/A 2 GP consultations pbpa between the ages of 2 and 12 2 GP consultations pbpa between the ages of 2 and 12 1 GP Consultation pbpa Between the ages of 2 and 12 years 1 GP Consultation pbpa Between the ages of 2 and 12 years 1 GP Consultation pbpa Between the ages of 2 and 12 years 1 GP Consultation pbpa Between the ages of 2 and 12 years Limited to R2 000 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 400 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 400 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 400 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 000 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 000 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R1 000 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) Limited to R700 pfpa. Benefits to Choose From: - GP Consultation - Biokineticist Consultation - Dietician Consultation - Physio Consultation - Wearable Devices (As Approved) - Smoking Cessation Program (As Approved) HEALTH AND WELLNESS ASSESSMENT WELLNESS EXTENDER CHRONIC DISEASE MANAGEMENT CHRONIC MEDICATION LIMIT NUMBER OF CHRONIC CONDITIONS DSP FOR CHRONIC MEDICATION BIOLOGICAL DRUGS Non-PMB's: Limited to R11 850 pbpa and R23 600 pfpa. PMB's: Unlimited at DSP R9 700 pbpa, to a Maximum of R20 100 pfpa, Thereafter PMB’s Unlimited. Formulary applies Limited to R8 250 pbpa and R16 500 pfpa. Thereafter PMB's Unlimited at DSP Limited to R8 250 pbpa and R16 500 pfpa. Thereafter PMB's Unlimited at DSP Unlimited subject to Formulary and DSP Unlimited subject to Formulary and DSP Unlimited subject to Formulary and DSP Unlimited subject to Formulary and DSP 60 Conditions 59 Conditions 44 Conditions 44 Conditions 27 PMB Conditions 27 PMB Conditions 27 PMB Conditions 27 PMB Conditions Pharmacy Direct Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) Pharmacy Direct (40% co-payment at non DSP) R210 400 pfpa for Oncology Related Treatment and R168 300 pfpa for Non-Oncology Related Treatment R105 200 pfpa for Oncology Related Treatment (10% Co-Payment Applies) N/A N/A N/A N/A N/A N/A BONITAS PRODUCT COMPARISON 2016 Please note: The information contained in this brochure is subject to approval by the Council for Medical Schemes. Terms, conditions and Scheme rules apply. Version CMS1. Product Comparison 2016 Bonitas Medical Fund I 0860 002 108 I www.bonitas.co.za
Similar documents
2016 Bonitas Brochure Small
Please note: The information contained in this brochure is subject to approval by the Council for Medical Schemes. Terms, conditions and Scheme rules apply. Version CMS1.
More information