Bonitas Student 2016_small

Healthcare
for students
Bonitas Medical Fund l www.bonitas.co.za l 0860 002 108
Be even more independent
with your own medical aid
plan.
We know what’s it’s like to be a student: Young and free with the added pressure of
balancing your studies and your social life – often on a small budget. Be even more
independent with your own medical aid plan.
This affordable plan offers basic cover for doctors and hospitals alike – giving you one
less thing to worry about.
From just R368 a month, you get:
•
•
•
•
•
•
•
•
•
•
A dedicated network of hospitals and doctors located near your
tertiary institution for you to use
Unlimited hospital stays covered at 100% of the Bonitas Rate
Unlimited GP visits at contracted provider
Cover for x-rays and blood tests
Cover for specialists
Benefits for dentistry and optometry
Medicine for 27 chronic conditions delivered to you
A free wellness check, flu vaccine and HIV test
Dedicated customer services channels
And so much more.
Student application criteria:
・
Acceptance letter. The student should be able to produce proof of registration
・
Full time registered students.
・
Registered with any Institution of higher learning as recognised by Department
of Education within S.A boarders.
・
Age restriction, recommended at 28 year but open for final recommendation.
Please note: The information contained in this brochure is subject to terms and conditions. Scheme Rules apply.
2
3
You earn
Main member
Adult dependant
Child dependant
R500 or less
R368
R349
R173
R501 to R6 550
R753
R714
R355
R6 551 to R10 650
R916
R866
R420
R10 651 to R14 550
R1 493
R1 330
R566
R14 551 or more
R1 834
R1 633
R695
In-hospital benefits
Hospitalisation is covered at 100% of the Bonitas Rate at all hospitals on the
BonCap Network. You must pre-authorise your stay. 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.
There is no overall limit on your hospital cover. You will have cover for medical
admissions; childbirth (other than Caesarian sections done for non-medical
reasons) and certain surgical admissions.
You also get:
• Unlimited GP and Specialist consultations for network doctors while in
hospital
• R21 800 per family for blood tests in hospital
• R9 940 per family for CT scans and MRIs in hospital
• R3 700 for physical therapy (physiotherapy, occupational therapy and
biokinetics) and paramedical services in hospital
• Cover for general x-rays in hospital
• Cover for organ transplants for Prescribed Minimum Benefit conditions
• Cover for HIV immune deficiency (subject to MyCare registration and
protocols)
• Cover for physical rehabilitation using the preferred provider
• R12 250 per family for alternatives to hospitalisation such as nursing
• R325 per person for admission for medicine to take home when discharged
4
Out-of-hospital benefits
GP benefits that treat you right
You and your dependants get 12 GP consultations
each to use on the BonCap network. A maximum of
2 visits per family (maximum of R850) may be
out-of-network with a 20% co-payment.
Benefits for blood tests, x-rays and acute medicine
You get the following amount to cover blood tests, x-rays or acute medicine:
•
•
•
•
•
R1 580 for the main member only
R2 630 for the main member + 1 dependant
R3 150 for the main member + 2 dependants
R3 450 for the main member + 3 dependants
R3 800 for the main member + 4 or more dependants
Specialist benefits for the best of care
Specialist consultations are limited to 3 visits or R2 680 per beneficiary up to 5 visits or
R3 950 per family. This limit must cover all associated claims prescribed by the
specialist such as acute medicines, blood tests, x-rays and scans such as MRIs and CAT
scans.
Cover for over-the-counter medicine
BonCap members get R225 per person per year for over-the-counter medicine at
network providers. This is limited to a maximum of R80 per event, three times a year.
5
6
• A blood pressure test
• A glucose test
• A cholesterol test
• A BMI test
• A waist-to-hip measurement
You and your dependants get a wellness check each, once a year. This must be done at a registered
provider and includes:
Wellness benefits to keep you in tip-top condition
Optical benefits work on a 2-year cycle so you can only access your benefits once every 2 years.
You get:
• 1 pair of glasses per person for approved lenses and frames
• 1 eye exam per person per year
• R1 067 for contact lenses
You must use the preferred provider.
Optical benefits to help you see clearly
We cover you and your family for conservative dentistry (such as cleaning and polishing) as follows:
• 1 consultation per person per year
• 1 preventative treatment per person per year
• 1 set of plastic dentures per family every 2 years for beneficiaries over 21
(a 20% co-payment applies)
Dental benefits to put a smile on your face
Maternity benefits to bring your baby into the world
Your hospital stay will be covered at 100% of the Bonitas Rate provided that you
pre-authorise it and use a network hospital. You get R38 900 for neonatal care per
family per year. You’ll also get the Bonitas baby pack which features a beautiful baby
bag and goodies. Caesarian sections for non-medical reasons are not covered.
Cover for 27 chronic conditions
You and your dependants get cover for 27 chronic conditions. Your medicine will be
delivered to you by Pharmacy Direct.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Addison’s disease
Asthma
Bipolar disorder
Bronchiectasis
Cardiac failure
Cardiomyopathy
Chronic obstructive pulmonary
disease
Chronic renal disease
Coronary artery disease
Crohn’s disease
Diabetes insipidus
Diabetes Type 1
Diabetes Type 2
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
Dysrhythmias
Epilepsy
Glaucoma
Haemophilia
HIV/Aids
Hyperlipidaemia
Hypertension
Hypothyroidism
Multiple sclerosis
Parkinson’s disease
Rheumatoid arthritis
Schizophrenia
Systemic lupus erythematosus
Ulcerative colitis
You will have to pay a 40% co-payment for medicine not listed on the formulary or if
you do not use Pharmacy Direct. MyCare will be responsible for chronic and HIV
medication authorisation subject to pre-authorisation.
7
Oncology, chronic renal dialysis
and paramedical services are
covered for Prescribed Minimum
Benefit Conditions
These are covered at 100% of the Bonitas Rate and
a preferred provider must be used.
Get a boost with supplementary benefits
Our supplementary benefits are paid from risk so they won’t impact your
day-to-day or hospital benefits. They are designed to give you more value for
money.
• Preventative care subject to DSPs
• General health
• 1 x annual HIV test per beneficiary, per year
• 1 x annual Flu vaccine per beneficiary, per year
• Wellness screening
• 1 x assessment per beneficiary, subject to DSPs and limited to :
Blood pressure test
Glucose test
Cholesterol test
Body mass index
Waist to hip ratio assessment
The right choice for foreign students
•
•
•
•
Foreign students only pay for 10 months
Providers located near tertiary institutions
Get health tips, news and info when you log in to our health portal
Use our 24-hour trauma counselling line for support for any
traumatic event
8
Eastern Cape
Hospitals
GP
Free Sate
9
608
Gauteng
43
1746
Limpopo
4
GP
376
North West
11
322
Western Cape
GP
9
Hospitals
GP
14
1042
Hospitals
GP
7
416
Northern Cape
Hospitals
Hospitals
304
Mpumalanga
Hospitals
GP
GP
8
KwaZulu-Natal
Hospitals
GP
Hospitals
15
889
Hospitals
GP
3
108
Students have dedicated customer service channels
We offer BonCap members access to a customer service centre which
caters exclusively for them. This allows us to resolve queries and assist
you quickly and easily.
Call 0861 239 333 between 08:30 and 17:00, Monday to Friday.
Email us at [email protected]
Check us out online
Visit our website www.bonitas.co.za to learn more about our products
and services.
You can also join us on Facebook at
www.facebook.com/BonitasMedicalFund and get health tips, benefit
information and much more.
Contact your broker
If you have any questions, need assistance or are unsure of anything,
be sure to contact your broker.
10
Bonitas Medical Fund l www.bonitas.co.za l 0860 002 108