Bonitas Medical Fund
Maximise your benefit - Visit an In Network Provider
Your benefits are contractually better at a network provider - Scheme rules apply
To confirm that you or a dependent is entitled to optical benefit, SMS your request to 45119 with the following details:
Benefit,MembershipNumber,Surname,BirthDateDependent,MainMemberID,DependantNumber, UniqueMedicalAid Key
Example: SMS 45119 Message details: Benefit 277323232 Botha 19721220 7212205065089 0 12
Important information:
Replace each comma with a space in your SMS and ensure the details are accurate and only one space is between each requirement. Kindly make sure the birthdate is in the correct format as per the example. The information will return within 1 minute on a new SMS. The full benefit breakdown per dependent is available by logging in to the PPN website or a guideline is given below. Your schemes unique medical key is 12.
Boncap
2022 Optical benefit design
Each beneficiary is entitled to the following benefits within a two year benefit cycle from last claiming date.
Member can claim either Spectacles OR Contact Lenses
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff: PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 225
- OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 169
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
- Contact lenses: R 1 140 per beneficiary
BonClassic
2022 Optical Benefit Design
Each beneficiary can claim once every 24 months from last claiming date
Member can claim either Spectacles OR Contact Lenses
Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply
PPN 1 negotiated tariff structure applicable (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Subject to a bi-annual Family limit of R5 845 - Sub-limits for each beneficiary defined below:
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 1 110
- OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 833
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: R 1 880 per beneficiary
BonComplete
2022 Optical benefits:
Each beneficiary is entitled to the following benefits within a two year benefit cycle from last date of claiming.
Member can claim either Spectacles OR Contact Lenses
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Benefits are subject to available savings.
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- IN NETWORK/OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 855
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: R 2 105 per beneficiary
BonComprehensive
2022 Optical Benefit
Each beneficiary can claim once in a 24 month cycle from last claiming date
Optical limit of R 3 500 per beneficiary from available savings
Member can claim either Spectacles OR Contact Lenses
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated tariff : PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- Frame from subject to available beneficiary and savings limits
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: Subject to the available savings limit
BonFit
2022 Optical Benefit Design
Each beneficiary can claim once in a 12 month cycle subject to available savings
Member can claim either spectacles or contact lenses
PPN 1 tariffs applicable In Network Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- OUT OF NETWORK/REFUND VALUE : Frame subject to available savings
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: Subject to available savings
BonSave
2022 Optical Benefit Design
Each beneficiary can claim once in a 12 month cycle subject to available savings
Member can claim either Spectacles OR Contact Lenses
PPN 1 limits applicable In Network Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- NETWORK/OUT OF NETWORK/REFUND VALUE : Frame subject to available savings
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: Subject to available savings
BonStart
2022 Optical benefits:
Each beneficiary is entitled to a consultation
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed Scheme rate regardless of member paying cash for materials)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
Co-payment: Member is liable for a co-payment of R110 on the consultation in and out of network
In Network : Spectacles at Scheme rate
Out of Network: Spectacles at Industry rate
Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes
In Network : Contact Lenses at Scheme rate
Out of Network: Contact Lenses at Industry rate
Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes
BonStart Plus
2022 Optical benefits:
Each beneficiary is entitled to a consultation
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff : PPN 1 (Lenses are dispensed in network at an agreed Scheme rate regardless of member paying cash for materials)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
Co-payment: Member is liable for a co-payment of R55 on the consultation in and out of network
In Network : Spectacles at Scheme rate
Out of Network: Spectacles at Industry rate
Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes
In Network : Contact Lenses at Scheme rate
Out of Network: Contact Lenses at Industry rate
Member to pay cash for materials, claim to be submitted to the scheme for Tax purposes
Primary / Primary Select
2022 Optical benefit design
Each beneficiary is entitled to the following sub-limits within a two year benefit cycle from the last claiming date subject to available family limit.
Member can claim either Spectacles OR Contact Lenses
Bi-annual Family limit of R 5 163
Forensic protocols and AI screening included in design - The benefits are a guideline and scheme rules apply
Negotiated Tariff: PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 525
- OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 394
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
- Contact lenses: R 1 295 per beneficiary
Standard / Standard Select
2022 Optical benefit design
Each beneficiary is entitled to the following benefits within a two year benefit cycle from the last claiming date.
Member can claim either Spectacles OR Contact Lenses
Bi-annual Family limit of R 6 700 Beneficiary sub-limits subject to family limit and defined below
Forensic protocols and AI screening included in design
The benefits are a guideline and scheme rules apply
Negotiated Tariff: PPN 1 (Lenses are dispensed in network at an agreed network rate. The same product out of network may result in co-payments if an out of network provider dispenses at industry rates.)
Network: One Comprehensive Consultation (Refraction, Tonometry, Visual Field Screening and AI)
OR
Out of Network: Refraction to the value of R350
- IN NETWORK : Frame and Lens Enhancement benefit up to the value of R 1 275
- OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 956
- One pair of either Single Vision or Bifocal or Multifocal clear standard lenses
Contact lenses: R 1 965 per beneficiary
- Boncap
- BonClassic
- BonComplete
- BonComprehensive
- BonFit
- BonSave
- BonStart
- BonStart Plus
- Primary / Primary Select
- Standard / Standard Select
