BonSave Product Information

This benefit covers medical expenses incurred in hospital, as well as major medical events e.g. oncology. All hospital admissions, oncology treatment plans and renal dialysis require pre-authorisation by Hospital Benefit Management (HBM) except in the case of emergencies.

Overall Annual Limit - Unlimited

Benefits payable at 150% of the Bonitas rate

Sub-limits applicable:
GP & Specialist Consultants	Unlimited, 150% Bonitas rate
Pathology	Unlimited
Radiology (Specialised & General)	Unlimited
Paramedic/Auxiliary Services e.g. physiotherapy, speech therapy, occupational therapy	Unlimited
Oncology	Unlimited, Sub-limit of R250 000 for medicines
Organ Transplants	Unlimited
Renal Dialysis	Unlimited
Maxillo Facial Surgery	Unlimited, excluding orthognatic surgery
Medication to take out (TTO)	R 250 per beneficiary, per admission
Physical Rehabilitation	R30 000 per family

	Dental Benefit Table
	Consultations	2 annual check-ups per beneficiary. Covered at the NHRPL tariff.
	X-rays: Intra-oral	Covered at the NHRPL tariff
	X-rays: Extra-oral	1 in a 3 year period Additionalbenefit may be considered where specialised dental treatment planning/follow up is required.
	Oral Hygiene	2 annual scale and polish treatments per beneficiary. No benefit for oral hygiene instructions. No benefit for adult fluoride
	Fillings	Covered at the NHRPL tariff. Benefit for re-treatment of a tooth is subject to clinical protocols.
	Root Canal Therapy Extractions	Covered at the NHRPL tariff where clinical protocols apply.
	Plastic Dentures	One set of plastic dentures (an upper and a lower) per beneficiary in a 4 year period. Covered at the NHRPL tariff
	Partial Metal Frame Dentures	One partial frame (an upper or a lower) per beneficiary in a 5 year period. Covered at the NHRPL tariff. Full metal dentures are not covered.
	Crown and Bridge* A bridge comprises of two or more crown units, which are payable from the available Crown and Bridge benefit.	Pre-authorisation is required. 2 crown units per family per year. Benefits for crowns are granted once per tooth in a 5 year period. Covered at the NHRPL tariff.
	Implants*	No benefit
	Orthodontics*	Benefit on pre-authorisation will be applied to cases assessed as treatment mandatory, as per orthodontic indices. A 25 % copayment of the Scheme Orthodontic tariff applies. Benefit is limited to individuals younger than 18 years of age. Orthognathic surgery is not covered
	Periodontics*	Benefit is limited to conservative, non-surgical therapy only (root planing). Benefit will be applied to members who are registered on the Perio Programme. Surgical periodontics is a scheme exclusion.
	Maxillo-Facial Surgery	Surgery in the dental chair: Covered at the NHRPL tariff. See Surgery Exclusion Summary Surgery in hospital: See Hospitalisation* Note: Benefit for Temperomandibular Joint (TMJ) therapy is limited to non-surgical intervention/treatments.
	Hospitalisation (general anaesthetic) *	Pre-authorisation is required. Certain Maxillo Facial procedures are covered inhospital, subject to admission protocols. See Exclusion Summary. General anaesthetic benefits are available for very young children 0-5 years for extensive dental treatment. Multiple hospital admissions are not covered.
	Laughing gas in dental rooms	Covered at the NHRPL tariff.
	IV conscious sedation in rooms*	Pre-authorisation is required Benefit is limited to extensive dental treatment where clinical protocols apply.