Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product,...

32
2015 Product Brochure Bonitas Medical Fund I 0860 002 108 I www.bonitas.co.za

Transcript of Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product,...

Page 1: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

2015

ProductBrochure

Bonitas Medical Fund I 0860 002 108 I www.bonitas.co.za

Page 2: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 2

You can’t put a priceon experience…

With a proudly South African heritage spanning over 32 years, Bonitas has an intimate understanding of how the healthcare industry works. Our aim is to make quality healthcare accessible to all South Africans and add value to their lives.

Affordable and generous, our benefits are designed to give our members more value for money. We have a wide range of products that are simple to understand so you know exactly what you’re covered for. They’re also easy to use, ensuring you get the support you need when you need it.

Our members know that when things get tough, we’re there to support them and take care of the little details so that they can receive the best of care and focus on getting better.

Please note: The information contained in this brochure is subject to approval by the Council for Medical Schemes. Terms, conditions and Scheme Rules apply.

Page 3: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 3

Why chooseBonitas?

We’re South Africa’s second largest open medical schemeWe cover 293 700 main members and 650 600 lives in total.

Our reputation speaks for itselfFinancially sound and reliable, we have over 32 years of experience in the healthcare industry.

We support our membersWe aim to provide value-for-money healthcare benefits and add value to our members’ lives.

We pay out more claims than any other open medical scheme – 93%We’re fully committed to making healthcare more affordable for all South Africans and pay out 93% of all claims – the highest by an open medical scheme.

We:• Have the largest GP network in SA• Are the only medical scheme to pay for dental benefits

from risk

• Offer free flu vaccines and HIV tests on all options• Pay supplementary benefits from risk so savings and day-

to-day benefits last longer

Check us out onlineVisit our website at www.bonitas.co.za to learn more about our products.

Main members Dependants

Page 4: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 4

INDEX1.BonComprehensive

2.BonClassic

3.Standard

4.BonSave

5.Primary

6.BonEssential

7.BonCap

8.Contact us

Page 5: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 5

Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive and exclusive benefits that cater for young and old alike. This elite option is perfect for those who appreciate high-quality, class and superior benefits. It offers rich benefits so that you and your loved ones have comprehensive cover and care.

What it costs

Hospital benefitsUnlimited hospitalisation covered at 300% of the Bonitas Rate at any hospitalBonComprehensive members have unlimited hospitalisation, at any hospital in South Africa. This is covered at 300% of the Bonitas Rate.

You also get the following:

BonComprehensive

Main member Adult dependant Child dependant

R4 488 R4 232 R913Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital• Unlimited pathology covered at 100% of the Bonitas Rate

in hospital• Unlimited radiology covered at 100% of the Bonitas Rate

in hospital• Unlimited paramedical services covered at 100% of the

Bonitas Rate in hospital• Unlimited maxillo-facial surgery covered at 100% of the

Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Unlimited cover for organ transplants while in hospital• Unlimited cover for HIV immune deficiency (subject to Aid for

AIDS registration and protocols)• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R450 per person per admission for medicine on discharge

Page 6: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 6

Out-of-hospital benefitsAbundant savings and a threshold benefitYou and your dependants get savings to use for GP and specialist consultations, pathology, optometry, acute and over-the-counter medication, paramedical services and basic and specialised dentistry.

Once your savings are exhausted, you will have to pay for the above yourself until you reach the amount in the self-payment gap, then your threshold benefit will kick in and you’ll have access to more benefits.

Please note: The threshold benefits is unlimited and 25% co-payment may apply to certain procedures. Limits and scheme rules apply.

Dental benefits to put a smile on your faceBasic and specialised dentistry is covered from your savings. This is subject to scheme protocols. A 25% co-payment applies in threshold.

Optical benefits to help you see clearlyOptometry is covered from savings and limited to R2 600 per person. A 25% co-payment applies in threshold.

Paramedical services are also coveredParamedical services such as occupational therapy, podiatry, speech therapy, dietetics and physiotherapy will be paid from savings. A 25% co-payment will apply in threshold.

Generous oncology benefitsOn BonComprehensive you get R504 000 per family for the treatment of cancer. This can be used in and out of hospital. There is also a biological benefit of R200 000 per family. This must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas rate at any hospital or dialysis centre in South Africa.

Maternity benefits that bring your baby into the world with the best startBonComprehensive covers the following maternity benefits from risk so it won’t impact your savings:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Main member Adult dependant Child dependant

Savings R13 464 R12 696 R2 736

Self-payment gap R997 R624 R692

Threshold R14 461 R13 320 R3 428

• 12 consultations while you’re pregnant• Two 2D ultrasounds• Antenatal classes to the value of R1 060

• Unlimited hospitalisation• A private ward after delivery• Four consultations with a midwife after you give birth

Page 7: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 7

Wellness benefits to keep you in tip-top conditionBonComprehensive offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Extensive cover for Chronic ConditionsBonComprehensive offers generous and extensive benefits for chronic conditions including cover for 54 chronic conditions, access to the Centre for Diabetes and Endocrinology and a limit of R160 000 for biological drugs.

BonComprehensive offers cover for 54 chronic conditionsThis is limited to R11 250 per beneficiary and R22 450 per family on the Comprehensive Formulary.

You will have to pay a 40% co-payment for medicine not listed on the formulary. If you go over these limits you will be covered for Prescribed Minimum Benefit conditions on the Restrictive Formulary using Pharmacy Direct.

Elite access to the Centre for Diabetes and EndocrinologyMembers with diabetes also have access to the Centre for Diabetes and Endocrinology which offers:

R160 000 per family for biological drugs Boasting cutting edge technology, biological drugs include antibodies, interleukins, and vaccines made from living cells. They are most often used in the treatment of cancer.

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your savings or hospital benefits. They can be used for treatment in and out of hospital and are designed to give you more value.

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

1. Acne2. Addison’s disease3. Allergic rhinitis4. Ankylosing spondylitis 5. Attention Deficit Disorder

(5-18 year olds)6. Asthma7. Barrett’s oesophagus8. Behcet’s disease9. Bipolar disorder10. Bronchiectasis11. Cardiac failure12. Cardiomyopathy13. Chronic obstructive pulmonary

disease14. Chronic renal disease15. Coronary artery disease16. Crohn’s disease17. Depression

18. Dermatitis19. Diabetes insipidus 20. Diabetes Type 121. Diabetes Type 222. Dysrhythmias23. Eczema24. Epilepsy25. Gastro-Oesophageal Reflux

Disorder26. Generalised anxiety disorder27. Glaucoma28. Gout29. Haemophilia30. Huntington’s disease31. Hyperlipidaemia32. Hypertension33. Hypoparathyroidism34. Hypothyroidism35. Multiple sclerosis

36. Myasthenia Gravis37. Narcolepsy38. Neuropathies39. Obsessive compulsive disorder 40. Osteoporosis41. Paget’s disease42. Panic disorder43. Parkinson’s disease44. Pemphigus45. Polyarteritis nordosa46. Post-traumatic stress syndrome47. Pulmonary interstitial fibroids48. Rheumatoid arthritis49. Schizophrenia50. Systemic lupus erythematosus51. Systemic sclerosis52. Tourette’s syndrome53. Ulcerative colitis54. Zollinger-Ellison syndrome

• Consultations with a specialist or accredited diabetes doctor• Wide-ranging diabetes education with a registered nurse

• Dietary advice from a dietician• A 24-hour emergency hotline

Page 8: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Product Brochure 2015 Page 8

Ensure peace of mind with mental health benefitsBonComprehensive members get R38 200 per family for mental health. This can be used in and out of hospital and must be pre-authorised. Up to R12 750 of the benefit can be used for consultations.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Preventative care to help you stay healthyEarly detection makes prevention possible. Our preventative care benefit offers the following screening procedures:

Infant Paediatric Benefit for children under 2This benefit can be used at a GP or paediatrician and offers:

Childhood illness benefit to keep your kids healthyThis benefit gives each of your children between 2 and 12 years old, 2 GP consultations per year.

Benefits for appliances such as wheelchairs and hearing aidsWe offer the following benefits:

You also get:

• 1 mammogram every 3 years for females aged 50 to 74• 1 pap smear every 3 years for females aged 21 to 65• 1 bone density test for females over 65• 1 Prostate Specific Antigen test for men aged 55 to 69 who are considered to be at high risk, after a thorough discussion with

their doctor• 1 Pneumococcal vaccination per person aged 65 and older• 1 Faecal Occult blood test per person aged between 50 and 75• 1 lipogram every 5 years for members over 20• 1 HIV test and flu vaccine per person• 1 TSH test for children below 1 month • Immunisation for children up to 12

• 3 consultations per child for children under 1 year old• 2 consultations per child for children between 1 and 2 years old

• R7 200 per family for general appliances such as wheelchairs• R21 000 per family every two years for hearing aids (a 10% co-payment applies)• R3 700 per person for foot orthotics (a 10% co-payment applies)• Cover for stoma products and CPAP machines that may exceed the general appliances limit by R5 050• Unlimited cover for oxygen and home ventilation if pre-authorised

• R16 900 per family for refractive surgery covered at 100% of the Bonitas Rate• R168 000 per family for cochlear implants• R135 000 per family for internal nerve stimulators• R25 500 per family for specialised radiology out of hospital• R44 900 per family for internal and external prostheses• Emergency medical transport from ER24

If you require and appreciate a select product that’s a cut-above the rest then BonComprehensive is the choice for you.

Page 9: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 9

One of the most generous options, BonClassic, offers quality cover without you having to break the bank. The perfect blend of the modernity and tradition, BonClassic boasts superior benefits at affordable rates. It offers rich cover for you and your loved ones with added boosts to help your benefits last longer.

What it costs

Hospital benefitsUnlimited hospitalisation at 100% of the Bonitas RateBonClassic covers all major hospital events including oncology treatment, organ transplants and renal dialysis.

You also get the following:

BonClassic

Main member Adult dependant Child dependant

R2 921 R2 509 R721Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital• Unlimited pathology covered at 100% of the Bonitas Rate

in hospital• Unlimited radiology covered at 100% of the Bonitas Rate

in hospital• Unlimited paramedical services covered at 100% of the

Bonitas Rate in hospital• Unlimited maxillo-facial surgery covered at 100% of the

Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Unlimited cover for organ transplants while in hospital• Unlimited cover for HIV immune deficiency for Prescribed

Minimum Benefit conditions (subject to Aid for AIDS registration and protocols)

• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R380 per person per admission for medicine on discharge

Page 10: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 10

Out-of-hospital benefitsUse your savings for consultations and acute medicineYou and your dependants get savings to use for GP and specialist consultations, pharmacy-advised therapy and acute medicine.

Once you have used all your savings, specialists will be paid from risk at 130% of the Bonitas rate.

Get even more value with these benefit boostsBonClassic is designed to help you get more value for your money. As a result you get the following:

Dental benefits to put a smile on your faceBasic dentistry is covered at R3 800 per family. Specialised dentistry (such as advanced dentistry, minor oral surgery and orthodontic treatment) is covered at R4 550 per family.

Optical benefits to help you see clearlyOptical benefits work on a 2-year cycle so you can only access your benefits once every two years. You get:

Eye tests are covered at R460 per person at a preferred provider and at R310 per person at a non-network provider.

Paramedical services are also coveredParamedical services such as occupational therapy, podiatry, speech therapy, dietetics and physiotherapy will be paid as follows:

Generous oncology benefitsOn BonClassic you get R334 500 per family at a preferred provider for the treatment of cancer. This can be used in and out of hospital and must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas rate at a Prefered Provider.

Main member Adult dependant Child dependant

Savings R5 256 R4 524 R1 296

• R2 550 per person (limited to R5 600 per family) for pathology• R2 550 per person (limited to R3 930 per family) for general

radiology

• R1 250 per person (limited to R2 550 per family) for physical therapy

• R5 060 per family• R700 per person for frames• R150 per lens per person for single vision lenses

• R325 per lens per person for bifocal lenses• R600 per lens per person for multifocal lenses• R1 550 per lens per beneficiary for contact lenses

• R2 440 for the main member• R3 700 for the main member + 1 other member• R4 300 for the main member + 2 other members

• R4 550 for the main member + 3 other members• R4 900 for the main member + 4 or more members

Page 11: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 11

Maternity benefits that bring your baby into the world with the best startBonClassic covers the following maternity benefits from risk so it won’t impact your savings:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionBonClassic offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Comprehensive cover for Chronic ConditionsBonClassic offers generous and extensive benefits for chronic conditions including cover for 63 chronic conditions and a limit of R100 000 for biological drugs.

BonClassic offers cover for 63 chronic conditions

This is limited to R9 200 per beneficiary and R19 100 per family on the Restrictive Formulary. Pharmacy Direct, our designated service provider, will deliver the medicine to you. If you do not use Pharmacy Direct or use a medicine which is not on the formulary a 40% co-payment will apply. If you go over these limits you will be covered for Prescribed Minimum Benefit conditions.

R100 000 per family for biological drugs Boasting cutting edge technology, biological drugs include antibodies, interleukins, and vaccines made from living cells. They are most often used in the treatment of cancer. A 10% co-payment applies for biological drugs. This benefit is subject to clinical protocols.

• 12 consultations while you’re pregnant• Two 2D ultrasounds• Antenatal classes to the value of R1 040

• Unlimited hospitalisation• Four consultations with a midwife after you give birth

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

1. Addison’s disease2. Alzheimer’s disease3. Angina4. Ankylosing spondylitis5. Asthma6. Attention Deficit Disorder (in 5-18

year olds)7. Barrett’s oesophagus8. Benign prostatic hypertrophy9. Bipolar disorder10. Bronchiectasis11. Bulimia Nervosa12. Cancer13. Cardiac Arrhythmias14. Cardiac failure15. Cardiomyopathy16. Chronic bronchitis17. Chronic obstructive pulmonary

disease18. Chronic renal disease19. Coronary artery disease20. Crohn’s disease

21. Cushing syndrome22. Cystic Fibrosis23. Deep vein thrombosis24. Depression25. Dermatomyositis26. Diabetes insipidus27. Diabetes Type 128. Diabetes Type 229. Dysrhythmias30. Eczema31. Emphysema32. Epilepsy33. Gastro-Oesophageal Reflux Disorder34. Generalised anxiety disorder35. Glaucoma36. Gout37. Haemophilia38. Hormone replacement therapy39. Hyperlipidaemia40. Hypertension41. Hypoparathyroidism42. Hypothyroidism

43. Infective Endocarditis44. Ischaemic heart disease45. Motor neuron disease46. Multiple sclerosis47. Obsessive compulsive disorder48. Osteoporosis49. Paget’s disease 50. Panic disorder51. Paraplegia and Quadreplegia52. Parkinson’s disease53. Polyarteritis nordosa54. Post-traumatic stress syndrome55. Pulmonary interstitial fibrosis56. Rheumatoid arthritis57. Schizophrenia58. Scleroderma59. Systemic lupus erythematosus60. Thromboangitis Obliterans61. Tourette’s syndrome62. Ulcerative colitis63. Zollinger-Ellison syndrome

Page 12: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 12

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your savings or hospital benefits. They can be used for treatment in and out of hospital and are designed to give you more value.

Ensure peace of mind with mental health benefitsBonClassic members get R33 600 per family for mental health. This can be used in and out of hospital and must be pre-authorised. Up to R13 150 of the benefit can be used for consultations.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Benefits for appliances such as wheelchairs and hearing aidsWe offer the following benefits:

You also get:

• R6 700 per family for general appliances such as wheelchairs, stoma products and CPAP machines

• R13 800 per family every three years for hearing aids (a 10% co-payment applies)

• R3 700 per person for foot orthotics (a 10% co-payment applies)

• Unlimited cover for oxygen and home ventilation if pre-authorised

• R168 000 per family for cochlear implants• R23 600 per family for specialised radiology in and

out of hospital

• R44 500 per family for internal and external prostheses• 1 HIV test and flu vaccine per person• Emergency medical transport from ER24

If you want top-notch care that covers the needs of you and your loved ones, then BonClassic is the option for you.

Page 13: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 13

Perfect for families, the Standard Option offers top quality cover at affordable prices. Featuring rich benefits that ensure you get the best of care, this option is definitely of a high standard.

What it costs

Hospital benefitsUnlimited hospitalisation at 100% of the Bonitas RateGet full cover for hospital stays at any private hospital in South Africa. Hospitalisation is covered at 100% of the Bonitas Rate. We cover all major hospital events including oncology treatment and renal dialysis.

You also get the following:

Standard

Main member Adult dependant Child dependant

R2 406 R2 081 R703Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital• Unlimited pathology covered at 100% of the Bonitas Rate

in hospital• Unlimited radiology covered at 100% of the Bonitas Rate

in hospital• Unlimited paramedical services covered at 100% of the

Bonitas Rate in hospital• Unlimited maxillo-facial surgery covered at 100% of the

Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Unlimited cover for organ transplants while in hospital• R26 400 cover for HIV immune deficiency (subject to Aid for

AIDS registration and protocols)• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R380 per person per admission for medicine on discharge

Page 14: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 14

Out-of-hospital benefitsUse your savings as you chooseYour savings can be used for acute medicine, consultations, pathology, radiology and just about any out-of-hospital claim. All claims will be paid from savings first before you use your generous day-to-day benefits. As an added bonus if you don’t use your savings they will be carried over to the next year.

Generous day-to-day benefits to ensure you get the best of careYou and your loved ones get day-to-day benefits to use for GP and specialist consultations and pharmacy-advised therapy.

Please note: Day-to-day benefits include savings and claims paid from savings. Sub-limits apply as shown below.

GP sub-limits to ensure you’re treated rightYou and your dependants get savings to use for GPs in and out of the Bonitas network. This is subject to the overall limit for day-to-day benefits.

Sub-limit for pharmacy advised therapyYou get R2 000 per family for pharmacy advised therapy such as over-the-counter medicine. This is limited to R660 per beneficiary.

Sub-limits for other out-of-hospital claimsThis can be used for out-of-hospital radiology, pathology, paramedical services (such as audiology, physiotherapy, occupational therapy and so on) and specialist consultations if referred by your doctor. This is subject to the overall limit for day-to-day benefits.Each female member gets one gynaecologist visit a year without referral while each child under 2 can visit the paediatrician without referral. You can also visit an ophthalmologist and oncologist without referral.

Optical benefits to help you see clearlyOptical benefits work on a 2-year cycle so you can only access your benefits once every two years. You get:

Eye tests are covered at R460 per person at a preferred provider and at R310 per person at a non-network provider. You’ll also get a bonus of R140 for using a preferred provider.

• R5 270 per family• R800 per person for frames• R150 per lens per person for single vision lenses

• R325 per lens per person for bifocal lenses• R600 per lens per person for multifocal lenses• R1 650 per lens per beneficiary for contact lenses

Main member only R8 375Main member + 1 dependant R12 640Main member + 2 dependants R14 000Main member + 3 dependants R15 335Main member + 4 or more dependants R16 845

Day-to-day benefits

Main member only R3 400 (only R1 100 can be used at GPs outside our network)Main member + 1 dependant R5 000 (only R1 700 can be used at GPs outside our network)Main member + 2 dependants R5 500 (only R1 850 can be used at GPs outside our network)Main member + 3 dependants R5 800 (only R1 950 can be used at GPs outside our network)Main member + 4 or more dependants R6 300 (only R2 100 can be used at GPs outside our network)

GP benefit

Main member Adult dependant Child dependant

R1 152 R996 R336

Main member only R4 975Main member + 1 dependant R7 640Main member + 2 dependants R8 500Main member + 3 dependants R9 535Main member + 4 or more dependants R10 545

Out-of-hospital benefits

Page 15: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 15

Dental benefits to put a smile on your faceWe cover you and your family for conservative dentistry (such as cleaning and polishing) and specialised dentistry (such as crowns, bridges and orthodontic treatment). This is based on the Bonitas Dental Tariff and clinical protocols.

Generous oncology benefitsOn the Standard Option you get R280 800 per family at a preferred provider for the treatment of cancer. This can be used in and out of hospital and must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas Rate at a Preferred Provider.

Maternity benefits that bring your baby into the world with the best startWe cover the following maternity benefits from risk so it won’t impact your other benefits:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionThe Standard Option offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Extensive cover for Chronic ConditionsThe Standard Option offers cover for 43 chronic conditions.

This is limited to R7 850 per beneficiary and R15 700 per family on the Comprehensive Formulary. You will have to pay a 40% co-payment for medicine not listed on the formulary. If you go over these limits you will be covered for Prescribed Minimum Benefit conditions on the Restrictive Formulary using Pharmacy Direct.

• 12 consultations while you’re pregnant• Two 2D ultrasounds• Antenatal classes to the value of R1 000

• Unlimited hospitalisation• Four consultations with a midwife after you give birth

1. Acne2. Addison’s disease3. Allergic rhinitis4. Ankylosing spondylitis5. Asthma6. Attention Deficit Disorder (5-18yr)7. Barrett’s oesophagus8. Behcet’s disease9. Bipolar disorder10. Bronchiectasis11. Cardiac failure12. Cardiomyopathy13. Chronic obstructive pulmonary

disease14. Chronic renal disease

15. Coronary artery disease16. Crohn’s disease17. Depression18. Dermatitis19. Diabetes insipidus20. Diabetes Type 121. Diabetes Type 222. Dysrhythmias23. Eczema24. Epilepsy25. Gastro-Oesophageal Reflux

Disorder26. Glaucoma27. Gout28. Haemophilia

29. Hyperlipidaemia30. Hypertension31. Hypothyroidism32. Multiple sclerosis33. Narcolepsy34. Obsessive compulsive disorder35. Panic disorder36. Parkinson’s disease37. Post-traumatic stress syndrome38. Rheumatoid arthritis39. Schizophrenia40. Systemic lupus erythematosus41. Tourette’s syndrome42. Ulcerative colitis43. Zollinger-Ellison syndrome

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

Page 16: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 16

Elite access to the Centre for Diabetes and EndocrinologyMembers with diabetes also have access to the Centre for Diabetes and Endocrinology which offers:

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your other benefits. They can be used for treatment in and out of hospital and are designed to give you more value.

Ensure peace of mind with mental health benefitsYou get R33 100 per family for mental health. This can be used in and out of hospital and must be pre-authorised. Up to R12 900 of the benefit can be used for consultations.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Infant Paediatric Benefit for children under 2This benefit can be used at a GP or paediatrician and offers:

Childhood illness benefit to keep your kids healthyThis benefit gives each of your children between 2 and 12 years old, 2 GP consultations per year.

Benefits for appliances such as wheelchairs and hearing aidsWe offer the following benefits:

You also get:

• 2 consultations per child for children under 1 year old• 2 consultations per child for children between 1 and 2 years old

• R6 550 per family for general appliances such as wheelchairs• R13 000 per family every two years for hearing aids (a 10% co-payment applies)• Cover for stoma products and CPAP machines that may exceed the general appliances limit by R5 300• R3 700 per person for foot orthotics (a 10% co-payment applies)• Unlimited cover for oxygen and home ventilation if pre-authorised

• R167 800 per family for cochlear implants• R134 800 per family for internal nerve stimulators• The benefit of R21 300 per family is for out of hospital• R36 000 for internal and external prostheses• 1 HIV test and flu vaccine per person• Emergency medical transport from ER24

Get the best of care for you and your loved ones without breaking the bank with the Standard Option.

• Consultations with a specialist or accredited diabetes doctor• Wide-ranging diabetes education with a registered nurse

• Dietary advice from a dietician• A 24-hour emergency hotline

Page 17: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 17

Take total control of your benefits with BonSave, the flexible option that lets you decide how to use your savings. Designed to offer you cover when you need it most, while allowing you to customise your cover according to your needs, BonSave offers extensive hospital cover.

What it costs

Hospital benefitsHospitalisation covered at 150% of the Bonitas RateGet full cover for hospital stays. We cover all major hospital events including oncology treatment, renal dialysis and organ transplants.

You also get the following:

BonSave

Main member Adult dependant Child dependant

R1 711 R1 325 R514Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital for network specialists

• Unlimited pathology covered at 100% of the Bonitas Rate in hospital

• Unlimited radiology covered at 100% of the Bonitas Rate in hospital

• Unlimited paramedical services cover at 100% of the Bonitas Rate in hospital

• Unlimited maxillo-facial surgery covered at 100% of the Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Unlimited cover for organ transplants while in hospital• R26 300 cover for HIV immune deficiency (subject to Aid for

AIDS registration and protocols)• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R310 per person per admission for medicine on discharge

Page 18: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 18

You will have to pay a deductible for certain procedures as shown in the table below:

Out-of-hospital benefitsGenerous savings to use as you chooseYou and your dependants get savings to use for GP and specialist consultations, pathology, optometry, acute medicine and paramedical services such as speech therapy.

If you use all your savings for the year, your family will still get a maximum of 6 consultations to use (limited to 3 per person), if illness strikes. We’ll cover these at no extra cost to you.

Dental benefits to put a smile on your faceBasic dentistry is covered from risk. This is subject to DENIS clinical protocols and the Bonitas Dental Tariff.

Optical benefits to help you see clearlyOptometry including eye tests, frames and lenses, is covered from savings.

Paramedical services are also coveredParamedical services such as occupational therapy, podiatry, speech therapy, dietetics and physiotherapy will be covered from your savings.

Generous oncology benefitsOn BonSave you get R280 800 per family at a preferred provider for the treatment of cancer. This can be used in and out of hospital and must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas Rate at a Preferred Provider.

Main member Adult dependant Child dependant

Savings R3 492 R2 700 R1 056

1. Colonoscopy2. Conservative back treatment3. Cystoscopy4. Facet joint injections5. Flexible sigmoidoscopy6. Functional nasal surgery7. Gastroscopy8. Umbilical hernia repair9. Hysteroscopy (not endometrial

ablation)10. Myringotomy11. Tonsillectomy and adenoidectomy

(not PMBs)12. Varicose vein surgery

1. Arthroscopy2. Diagnostic laparoscopy3. Hysterectomy (except cancer

and PMBs)4. Percutaneous radiofrequency

ablations5. Percutaneous rhizotomies6. Laparoscopic appendectomy7. Laparoscopic nephrectomy

1. Nissen fundoplication (reflux surgery)

2. Back surgery including spinal fusion

3. Joint replacement (except PMBs)

4. Laparoscopic pyeloplasty5. Laparoscopic radical

prostatectomy

R1 000 deductible R2 500 deductible R5 000 deductible

Page 19: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 19

Maternity benefits that bring your baby into the world with the best startWe cover the following maternity benefits from risk so it won’t impact your savings:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionBonSave offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Chronic cover for Prescribed Minimum Benefits at a DSPBonSave gives you and your dependants full cover for 26 chronic conditions and delivers your medicine to you through Pharmacy Direct.

You will have to pay a 40% co-payment for medicine not listed on the formulary or if you do not use Pharmacy Direct.

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your savings or hospital benefits. They can be used for treatment in and out of hospital and are designed to give you more value.

Ensure peace of mind with mental health benefitsBonSave members get R26 300 per family for mental health. This can be used in and out of hospital and must be pre-authorised. Up to R12 900 of the benefit can be used for consultations.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Infant Paediatric Benefit for children under 2This benefit can be used at a GP or paediatrician and offers:

• 6 consultations while you’re pregnant• Two 2D ultrasounds• Antenatal classes to the value of R1 000

• Unlimited hospitalisation• Four consultations with a midwife after you give birth

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

1. Addison’s disease2. Asthma3. Bipolar disorder4. Bronchiectasis5. Cardiac failure6. Cardiomyopathy7. Chronic obstructive pulmonary

disease8. Chronic renal disease

9. Coronary artery disease10. Crohn’s disease11. Diabetes insipidus12. Diabetes Type 113. Diabetes Type 214. Dysrhythmias15. Epilepsy16. Glaucoma17. Haemophilia

18. Hyperlipidaemia19. Hypertension20. Hypothyroidism21. Multiple sclerosis22. Parkinson’s disease23. Rheumatoid arthritis24. Schizophrenia25. Systemic lupus erythematosus26. Ulcerative colitis

• 2 consultations per child for children under 1 year old • 1 consultation per child for children between 1 and 2 years old

Page 20: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 20

Childhood illness benefit to keep your kids healthyThis benefit gives each of your children between 2 and 12 years old, 1 GP consultation per year.

Benefits for appliances such as wheelchairs We offer the following benefits:

You also get:

• R5 950 per family for general appliances such as wheelchairs• Cover for stoma products and CPAP machines that may exceed the general appliances limit by R5 300• R3 700 per person for foot orthotics (a 10% co-payment applies)• Unlimited cover for oxygen and home ventilation if pre-authorised

• R19 000 per family for specialised radiology out of hospital• Cover for internal and external prostheses for Prescribed Minimum Benefit conditions• 1 HIV test and flu vaccine per person• Emergency medical transport from ER24

If you’re looking for cover that’s as adaptable as you are, then BonSave is the option for you.

Page 21: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 21

The Primary Option offers simple, fuss-free healthcare that ensures you and your loved ones are covered for emergencies and routine health checks alike.

What it costs

Hospital benefitsUnlimited hospitalisation at 100% of the Bonitas RateGet full cover for hospital stays at any private hospital in South Africa. Hospitalisation is covered at 100% of the Bonitas Rate. We cover all major hospital events including oncology treatment and renal dialysis.

You also get the following:

Primary

Main member Adult dependant Child dependant

R1 550 R1 213 R494 Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital for network specialists

• Unlimited pathology covered at 100% of the Bonitas Rate in hospital

• Unlimited radiology covered at 100% of the Bonitas Rate in hospital

• Unlimited paramedical services cover at 100% of the Bonitas Rate in hospital

• Unlimited maxillo-facial surgery covered at 100% of the Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Cover for organ transplants for Prescribed Minimum Benefit conditions

• R20 200 cover for HIV immune deficiency (subject to Aid for AIDS registration and protocols)

• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R310 per person per admission for medicine on discharge

Page 22: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 22

You will have to pay a deductible for certain procedures as shown in the table below:

Out-of-hospital benefitsGP benefits that treat you rightYou and your dependants get savings to use for GPs in and out of the Bonitas network.

Day-to-day benefits to help you stay healthyThe day-to-day benefit covers out-of-hospital radiology, pathology, paramedical services (such as audiology, physiotherapy, occupational therapy and so on) and specialist consultations if referred by your doctor.

Each female member gets one gynaecologist visit a year without referral while each child under 2 can visit the paediatrician without referral.

Over-the-counter medicine is coveredYou get R1 170 per family for pharmacy advised therapy. This is limited to R400 per beneficiary.

Dental benefits to put a smile on your faceBasic dentistry is covered from risk. This is subject to DENIS clinical protocols and the Bonitas Dental Tariff.

Optical benefits to help you see clearlyOptical benefits work on a 2-year cycle so you can only access your benefits once every two years. You get:

Eye tests are covered at R460 per person at a preferred provider and at R310 per person at a non-network provider. You’ll also get a bonus of R140 for using a preferred provider.

• R4 270 per family• R300 per person for frames• R150 per lens per person for single vision lenses

• R325 per lens per person for bifocal lenses• R600 per lens per person for multifocal lenses• R1 150 per lens per beneficiary for contact lenses

Main member only R1 600 (only R530 can be used at GPs outside our network)Main member + 1 dependant R3 000 (only R1 000 can be used at GPs outside our network)Main member + 2 dependants R3 500 (only R1 150 can be used at GPs outside our network)Main member + 3 dependants R3 800 (only R1 300 can be used at GPs outside our network)Main member + 4 or more dependants R4 300 (only R1 450 can be used at GPs outside our network)

GP benefit

Main member only R1 700Main member + 1 dependant R3 100Main member + 2 dependants R3 600Main member + 3 dependants R3 900Main member + 4 or more dependants R4 250

Day-to-day benefit

1. Colonoscopy2. Conservative back treatment3. Cystoscopy4. Facet joint injections5. Flexible sigmoidoscopy6. Functional nasal surgery7. Gastroscopy8. Umbilical hernia repair9. Hysteroscopy (not endometrial

ablation)10. Myringotomy11. Tonsillectomy and adenoidectomy

(not PMBs)12. Varicose vein surgery

1. Arthroscopy2. Diagnostic laparoscopy3. Hysterectomy (except cancer

and PMBs)4. Percutaneous radiofrequency

ablations5. Percutaneous rhizotomies6. Laparoscopic appendectomy7. Laparoscopic nephrectomy

1. Nissen fundoplication (reflux surgery)

2. Back surgery including spinal fusion

3. Joint replacement (except PMBs)

4. Laparoscopic pyeloplasty5. Laparoscopic radical

prostatectomy

R1 000 deductible R2 500 deductible R5 000 deductible

Page 23: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 23

Paramedical services are also coveredParamedical services such as occupational therapy, podiatry, speech therapy, dietetics and physiotherapy will be covered from your day-to-day benefit.

Generous oncology benefitsOn the Primary Option you get R135 000 per family at a preferred provider for the treatment of cancer. This can be used in and out of hospital and must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas Rate for Prescribed Minimum Benefit conditions.

Maternity benefits to bring your baby into the world with the best startWe cover the following maternity benefits from risk so it won’t impact your day-to-day benefits:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionThe Primary Option offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Chronic cover for Prescribed Minimum Benefits at a DSPThe Primary Option gives you and your dependants full cover for 26 chronic conditions and delivers your medicine to you through Pharmacy Direct.

You will have to pay a 40% co-payment for medicine not listed on the formulary or if you do not use Pharmacy Direct.

• 6 consultations while you’re pregnant• Two 2D ultrasounds

• Unlimited hospitalisation• Four consultations with a midwife after you give birth

1. Addison’s disease2. Asthma3. Bipolar disorder4. Bronchiectasis5. Cardiac failure6. Cardiomyopathy7. Chronic obstructive pulmonary

disease8. Chronic renal disease

9. Coronary artery disease10. Crohn’s disease11. Diabetes insipidus12. Diabetes Type 113. Diabetes Type 214. Dysrhythmias15. Epilepsy16. Glaucoma17. Haemophilia

18. Hyperlipidaemia19. Hypertension20. Hypothyroidism21. Multiple sclerosis22. Parkinson’s disease23. Rheumatoid arthritis24. Schizophrenia25. Systemic lupus erythematosus26. Ulcerative colitis

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

Page 24: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 24

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your other benefits. They can be used for treatment in and out of hospital and are designed to give you more value for money.

Ensure peace of mind with mental health benefitsPrimary Option members get R12 900 per family for mental health. This can be used in and out of hospital and must be pre-authorised. Up to R7 800 of the benefit can be used for consultations.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Infant Paediatric Benefit for children under 2This benefit can be used at a GP or paediatrician and offers:

Childhood illness benefit to keep your kids healthyThis benefit gives each of your children between 2 and 12 years old, 1 GP consultation per year.

Benefits for appliances such as wheelchairs and hearing aidsWe offer the following benefits:

You also get: • R10 600 per family for specialised radiology in and out of hospital• Cover for internal and external prostheses for Prescribed Minimum Benefit conditions• 1 HIV test and flu vaccine per person• Emergency medical transport from ER24

• 1 consultation per child for children under 1 year old• 1 consultation per child for children between 1 and 2 years old

• R5 900 per family for general appliances such as wheelchairs• R7 400 per family for hearing aids once every two years (a 10% co-payment applies)• Cover for stoma products and CPAP machines that may exceed the general appliances limit by R5 300• R3 700 per person for foot orthotics (a 10% co-payment applies)• Unlimited cover for oxygen and home ventilation if pre-authorised

If you like keeping things simple but want to ensure your loved ones have access to affordable healthcare, then the Primary Option is perfect for you.

Page 25: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 25

BonEssential is the ideal plan for healthier families and individuals who only really need cover for emergencies. BonEssential offers top-quality hospital cover at affordable prices with added Prescribed Minimum Benefits when you really need them.

What it costs

Hospital benefitsUnlimited hospitalisation at 100% of the Bonitas Rate Get full cover for hospital stays at any private hospital in South Africa. Hospitalisation is covered at 100% of the Bonitas Rate. We cover all major hospital events including oncology treatment and renal dialysis.

You also get the following:

BonEssential

Main member Adult dependant Child dependant

R1 191 R911 R349Your fourth and subsequent children will be covered free of charge.

• Unlimited GP and Specialist consultations while in hospital• Unlimited pathology covered at 100% of the Bonitas Rate

in hospital• Unlimited general and specialised radiology covered at

100% of the Bonitas Rate in hospital • Unlimited paramedical services covered at 100% of the

Bonitas Rate in hospital• Unlimited maxillo-facial surgery covered at 100% of the

Bonitas Rate in hospital (excluding orthognathic surgery)

• Unlimited physical therapy (physiotherapy and biokinetics) while in hospital

• Unlimited cover for organ transplants while in hospital• R26 300 cover for HIV immune deficiency (subject to Aid for

AIDS registration and protocols)• R26 300 in hospital for mental health benefits• R40 400 per family for physical rehabilitation• R13 500 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R310 per person per admission for medicine on discharge

Page 26: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 26

You will have to pay a deductible for certain procedures as shown in the table below:

Generous oncology benefitsOn BonEssential you get R280 800 per family at a preferred provider for the treatment of cancer. This can be used in and out of hospital and must be pre-authorised.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas Rate at a Preferred Provider.

Maternity benefits that bring your baby into the world with the best startWe cover the following maternity benefits from risk:

You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionBonEssential offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

• 6 consultations while you’re pregnant• Two 2D ultrasounds• Unlimited hospitalisation• Four consultations with a midwife after you give birth

• A blood pressure test• A glucose test• A cholesterol test• A BMI test• A waist to hip ratio measurement

1. Colonoscopy2. Conservative back treatment3. Cystoscopy4. Facet joint injections5. Flexible sigmoidoscopy6. Functional nasal surgery7. Gastroscopy8. Umbilical hernia repair9. Hysteroscopy (not endometrial

ablation)10. Myringotomy11. Tonsillectomy and adenoidectomy

(not PMBs)12. Varicose vein surgery

1. Arthroscopy2. Diagnostic laparoscopy3. Hysterectomy (except cancer

and PMBs)4. Percutaneous radiofrequency

ablations5. Percutaneous rhizotomies6. Laparoscopic appendectomy7. Laparoscopic nephrectomy

1. Nissen fundoplication (reflux surgery)

2. Back surgery including spinal fusion

3. Joint replacement (except PMBs)

4. Laparoscopic pyeloplasty5. Laparoscopic radical

prostatectomy

R1 000 deductible R2 500 deductible R5 000 deductible

Page 27: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 27

Chronic cover for Prescribed Minimum Benefits at a DSPBonEssential gives you and your dependants full cover for 26 chronic conditions and delivers your medicine to you through Pharmacy Direct.

You will have to pay a 40% co-payment for medicine not listed on the formulary or if you do not use Pharmacy Direct.

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your other benefits. They can be used for treatment in and out of hospital and are designed to give you more value for money.

Ensure peace of mind with mental health benefitsMental health is covered for Prescribed Minimum Benefit conditions.

Get medical cover while you’re on holidayThe international travel benefit ensures you and your dependants have access to medical care while travelling in a foreign country.

Childhood illness benefit to keep your kids healthyThis benefit gives each of your children between 2 and 12 years old, 1 GP consultation per year.

You also get:

1. Addison’s disease2. Asthma3. Bipolar disorder4. Bronchiectasis5. Cardiac failure6. Cardiomyopathy7. Chronic obstructive pulmonary

disease8. Chronic renal disease9. Coronary artery disease

10. Crohn’s disease11. Diabetes insipidus12. Diabetes Type 113. Diabetes Type 214. Dysrhythmias15. Epilepsy16. Glaucoma17. Haemophilia18. Hyperlipidaemia19. Hypertension

20. Hypothyroidism21. Multiple sclerosis22. Parkinson’s disease23. Rheumatoid arthritis24. Schizophrenia25. Systemic lupus erythematosus26. Ulcerative colitis

• Cover for internal and external prostheses for Prescribed Minimum Benefit conditions• 1 HIV test and flu vaccine per person• Emergency medical transport from ER24

If you want excellent medical care when you need it most, then BonEssential is the option for you.

Page 28: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 28

BonCap is our entry-level product that offers access to network providers and hospitals. Designed to help us achieve our aim of making private healthcare more affordable for all South Africans, BonCap offers basic day-to-day benefits and hospital cover.

What it costs

In-hospital benefitsUnlimited hospitalisation in the BonCap hospital network at 100% of the Bonitas Rate Hospitalisation is covered at 100% of the Bonitas Rate at all hospitals on the BonCap Network. You must pre-authorise your stay (except for emergencies).

A R5 350 co-payment must be paid if you use a non-network hospital (except for emergencies) or you do not get pre-authorisation.

BonCap

You earn Main member Adult dependant Child dependant

R500 or less R330 R313 R155

R501 to R6 100 R675 R640 R318

R6 101 to R9 950 R821 R776 R376

R9 951 to R13 590 R1 338 R1 192 R507

R13 591 or more R1 643 R1 463 R623

Page 29: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 29

You also get the following:

Out-of-hospital benefitsGP benefits that treat you rightYou and your dependants get 12 GP consultations to use on the BonCap network. A maximum of 2 visits per family may be out-of-network with 20% co-payment.

Specialist benefits for the best of careSpecialist consultations are limited to 3 visits or R2 550 per beneficiary up to 5 visits or R3 770 per family. This limit must cover all associated claims prescribed by the specialist such as acute medicines, pathology, basic radiology and specialised radiology.

Over-the-counter medicine is coveredBonCap members get R215 per person per year for over-the-counter medicine at network providers. This is limited to a maximum of R75 per event.

Dental benefits to put a smile on your faceWe cover you and your family for conservative dentistry (such as cleaning and polishing) as follows:

Optical benefits to help you see clearlyOptical benefits work on a 2-year cycle so you can only access your benefits once every two years. You get:

You must use the contracted provider.

Paramedical services are also covered for Prescribed Minimum BenefitsParamedical services such as occupational therapy, orthotics, podiatry, speech therapy, dietetics, social workers and nursing services will be covered for Prescribed Minimum Benefit conditions only.

Oncology is covered for Prescribed Minimum BenefitsOn BonCap, you get cover for oncology in and out of hospital. This must be pre-authorised and a network hospital must be used.

100% cover for chronic renal dialysisWe cover renal dialysis at 100% of the Bonitas rate for Prescribed Minimum Benefit conditions at a network provider.

• Unlimited GP and Specialist consultations for network doctors while in hospital

• R20 700 per family for pathology in hospital• R9 450 per family for CT scans and MRIs in hospital• R3 500 for physical therapy (physiotherapy, occupational

therapy and biokinetics) and paramedical services while in hospital

• Cover for maxillo-facial surgery excluding orthognathic surgery, surgery on tonsils and adenoids, grommets and circumcision for Prescribed Minimum Benefit conditions.

• Cover for organ transplants for Prescribed Minimum Benefit conditions

• Cover for general radiology in hospital• Cover for HIV immune deficiency (subject to MyCare

registration and protocols)• Cover for physical rehabilitation (subject to using the

contracted provider)• R11 650 per family for alternatives to hospitalisation such as

nursing and out-patient antibiotic therapy• R310 per person for admission for medicine on discharge

• 1 consultation per person per year• 1 preventative treatment per person per year• 1 set of plastic dentures per family, every two years for beneficiaries over the age of 21 and a 20% co-payment applies

• 1 pair of glasses per person (for approved lenses and frames) • 1 eye examination per person per year

Page 30: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 30

Maternity benefits that bring your baby into the world with the best startYou get R37 000 for neonatal care per family per year. Your hospital stay will be covered at 100% of the Bonitas Rate provided that you pre-authorise it and use a network hospital. You’ll also get the Bonitas baby pack which features a beautiful baby bag and goodies for both mom and baby.

Wellness benefits to keep you in tip-top conditionBonCap offers each member and their dependants one wellness assessment a year. This must be done by a registered provider and includes:

Chronic cover for Prescribed Minimum Benefits at a DSPBonCap gives you and your dependants full cover for 26 chronic conditions and delivers your medicine to you through Pharmacy Direct.

You will have to pay a 40% co-payment for medicine not listed on the formulary or if you do not use Pharmacy Direct.

Supplementary benefitsOur supplementary benefits are paid from risk so they won’t impact your day-to-day or hospital benefits. They can be used for treatment in and out of hospital and are designed to give you more value for money.

Ensure peace of mind with mental health benefitsMental health is covered for Prescribed Minimum Benefit conditions in and out of hospital at the contracted network providers.

Benefits for appliances such as wheelchairsWe offer the following benefits:

You also get:

• A blood pressure test• A glucose test• A cholesterol test

• A BMI test• A waist to hip ratio measurement

1. Addison’s disease2. Asthma3. Bipolar disorder4. Bronchiectasis5. Cardiac failure6. Cardiomyopathy7. Chronic obstructive pulmonary

disease8. Chronic renal disease

9. Coronary artery disease10. Crohn’s disease11. Diabetes insipidus12. Diabetes Type 113. Diabetes Type 214. Dysrhythmias15. Epilepsy16. Glaucoma17. Haemophilia

18. Hyperlipidaemia19. Hypertension20. Hypothyroidism21. Multiple sclerosis22. Parkinson’s disease23. Rheumatoid arthritis24. Schizophrenia25. Systemic lupus erythematosus26. Ulcerative colitis

• R4 450 per family for general appliances such as wheelchairs and stoma products• Unlimited cover for oxygen and home ventilation if pre-authorised

• Cover for internal prostheses for Prescribed Minimum Benefit conditions• Emergency medical transport from ER24

If you’re looking for basic cover and don’t mind using a specific network, then BonCap is the option for you.

Page 31: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Benefits 2015 Page 31

Contact us

Visit one of our walk-in centresResolve queries; get a new membership card and so much more at our walk-in centres.

PretoriaGround Floor, Benstra Building,473B Church Street, Arcadia,Pretoria

Vereeniging36 Merriman Avenue,Ground Floor,Vereeniging

SecundaGrand Palace, Unit 82,2302 Heinis Street,Secunda

Kathu6 Rietbok Street,Kathu,Northern Cape

PolokwaneGround Floor, Bonitas House,22 Hans van Rensburg Street,Polokwane

JohannesburgMathomo Mall, 115 Main Street,Marshalltown,Johannesburg

Northam180 Botha Street,Northam

BloemfonteinShop C7, 1st Floor, Middestad Centre,c/o Charles and West Burger Street,Bloemfontein

Rustenburg141 Fatima Bhayat Street,Rustenburg

Cape TownThe Icon Building, Ground Floor,Corner Lower Long Street andHans Strydom Avenue,Cape Town

Durban3rd Floor,67 Old Fort Road,Durban

Port ElizabethBlock 6, Greenacres Office Park,2nd Avenue, Newton Park,Port Elizabeth

Roodepoort37 Conrad Road,Florida North,Roodepoort

LephalaleOnverwacht Business,Mienie Building, Block C,Walter Sisulu Avenue,Lephalale

Call our customer service team on 0860 002 108Available between 08:30 and 17:00, Monday to Friday the Bonitas Call Centre is here to help you with everything you need.You can:

• Get hospital and specialised radiology authorisation• Authorise chronic medicine

• Get a tax certificate• Resolve queries

BonCap members have their own call centreCall 0861 239 333 between 08:30 and 17:00, Monday to Friday for assistance with BonCap queries.

Check us out onlineVisit our website at to learn more about our products. You can also join us on Facebook and get health tips, benefit information and much more. www.bonitas.co.za I www.facebook.co.za/BonitasMedicalFund

Page 32: Product Brochure - Aon South Africa · Product Brochure 2015 Page 5 Our premium product, BonComprehensive, is designed to meet the most arduous healthcare needs. It features extensive

Bonitas Medical Fund I 0860 002 108 I www.bonitas.co.za