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Bonitas

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
OR
  • OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 169
AND
  • 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
OR
  • OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 833
AND
  • 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
AND
  • 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
AND
  • 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
AND
  • 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 
AND
  • 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
OR
  • OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 394
AND
  • 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
OR
  • OUT OF NETWORK/REFUND VALUE : Frame and Lens Enhancement benefit up to the value of R 956
AND
  • One pair of either Single Vision or Bifocal or Multifocal clear standard lenses

Contact lenses: R 1 965 per beneficiary

Find your nearest PPN optometrist