- Standard and standard select move to traditional options: Bonitas has simplified the design of the Standard and Standard Select options. These plans will now move to a traditional, day to day design. The 4% savings portion, available in 2015 and 2016, has been removed. Accrued savings balances will be paid out or transferred to members, as applicable.
- Introducing boncomplete: BonComplete is a new savings plan boasting an above threshold benefit. It offers a range of rich benefits, including cover for 31 chronic conditions including ADD for children under 18.
- Sub-limit for over the counter medicine on standard and standard select: Although some members enjoyed a richer over the counter benefit in 2016, many found that their savings were exhausted early in theyear. To give members more choice on how to use their benefits, we have re-introduced an over the counter medicine sub-limit within the new increased day-to day benefit. Our rich GP benefit will remain as a stand-alone benefit, paid exclusively from risk
- Hearing aid benefits restructured: Co-payments for hearing aids on Standard and Standard Select have increased from 10% in 2016 to 20% in 2017. 24 months between claims for hearing aids will be required on BonComprehensive, BonClassic, Standard and Standard Select. This is as opposed to claims being allowed once in a 2 year cycle. In 2016, the Primary Option had a nominal benefit for hearing aids. This has been removed for 2017.
- Specialist referral is required where out-of-hospital specialist visits are paid from risk: Claims for specialist consultations without a valid referral from a GP will not be paid from risk. This will help enhance co-ordination of care. CHANGES FOR 2017 Please note: Product rules, limits, terms and conditions apply. Where there is a discrepancy between the content provided in this document, the website and the Scheme Rules, the Scheme Rules will prevail. The Scheme Rules are available on request. Benefits are subject to approval from the Council for Medical Schemes.
- Reduction of age for preventative care benefit for mammograms: Early detection of breast cancer is essential to its treatment. Mammograms are one of the most advanced diagnostic tools, as they can detect breast cancer up to two years before a tumour can be felt. Because breast cancer is one of the most common cancers in South Africa, we have followed best practice guidelines and reduced the minimum age for mammograms from 50 to 40 on BonComprehensive, BonClassic, Standard and Standard Select.
- Pneumococcal vaccines covered for members over 65 on all plans: We have also introduced cover for the pneumococcal vaccine on BonEssential and BonCap for members over 65. This vaccine prevents pneumonia infections, especially in older adults.
- Foot orthotics to be paid from available savings: In 2016, the benefit for foot orthotics was paid for from risk on BonComprehensive, BonClassic, Standard, Standard Select, Primary and BonSave. This benefit will now be paid for from available savings on BonComprehensive, BonClassic, BonComplete, BonSave and BonFit.
- Re-alignment of specialised radiology: Currently the limit for specialised radiology on Standard, Standard Select and BonSave applies to out-of-hospital tests only. However, in 2017, the benefit limit will apply to tests done in and out-of-hospital tests on these options. The majority of in-hospital specialised radiology is PMB and hence this change will not impact significnantly on in-hospital claims
- Amendment of optical benefits: We have amended the way our optical benefits work for 2017. Previously, members were entitled to these benefits once every two year cycle. However, in 2017, optical benefits can be accessed once in a 24 month period, based on the date of the previous optical claim. This will apply per beneficiary. This will apply to BonClassic, Standard, Standard Select and Primary.
- Physiotherapy for mental health admissions: Cover for physiotherapy in hospital will be excluded for mental health admissions on all options. This is to ensure appropriate care is provided to members.
- Increase on co-payments for elective hospital procedures: To limit the effect of rising hospital costs across our membership base, we have increased the co-payments for specific elective hospital procedures on BonSave, Primary, BonFit, and BonEssential. These increases will not affect members who are admitted for emergencies and PMB related conditions.
Source:Bonitas