2026 Rules Active
2026 Strategy Validated
Chronic Management with DSP Savings Hybrid
BonPrime Chronic Disease Management with Savings strategy verified
Covering 0 family members
2026 rates applied
Compare Alternatives
Actuarial Strategy Reference
This strategy is generated based on the 2026 Council for Medical Schemes (CMS) registered rules and actuarial pricing matrices.
VERIFIED: 2025-12-20 | SOURCE: SCHEME_BENEFIT_GUIDE_2026
Similar Situations
Key Terms Explained
Key Terms for this Strategy
- Network Restriction
- You must use hospitals and doctors listed in the scheme's specific network. Voluntary use of non-network providers will result in a heavy co-payment. [Source: Council for Medical Schemes Official Benefit Rules]
- Medical Savings Account (MSA)
- A fund of R6,252 included in your premium. You use this for day-to-day expenses like GP visits and scripts. [Source: Council for Medical Schemes Official Benefit Rules]
- Elective Procedure Co-payment
- A mandatory upfront fee you must pay to the hospital for specific scheduled surgeries that are not emergencies. [Source: Council for Medical Schemes Official Benefit Rules]
Common Questions
What happens if I use a non-network hospital? [BonPrime Chronic Disease Management with Savings]
You will be liable for a 30% co-payment on the hospital account if you voluntarily use a hospital outside the BonPrime Network. Strategy reference: ent-2026.
Is my cancer treatment unlimited? [BonPrime Chronic Disease Management with Savings]
No, while PMB conditions are covered, non-PMB oncology is limited to R224,100 per family. Once this limit is reached, there is 80% cover at a DSP. Strategy reference: ent-2026.
Do I have to pay upfront for an MRI? [BonPrime Chronic Disease Management with Savings]
Yes, you must pay a R2,240 co-payment per scan event, unless it is for a PMB condition. Strategy reference: ent-2026.
Is there a limit on hip replacements? [BonPrime Chronic Disease Management with Savings]
Yes, internal prostheses (like hip and knee replacements) are covered for PMB conditions only. There is no general benefit. Strategy reference: ent-2026.
What if I run out of savings? [BonPrime Chronic Disease Management with Savings]
Once your savings are depleted, your family gets 1 additional GP consultation paid by the scheme. You can also unlock up to R4,000 in 'Benefit Booster' for day-to-day expenses. Strategy reference: ent-2026.
Are my contraceptives covered? [BonPrime Chronic Disease Management with Savings]
Yes, contraceptives are covered up to R1,970 per family, but you must use the Designated Service Provider (Marara Pharmacy) to avoid a 40% co-payment. Strategy reference: ent-2026.
Is there a co-payment for gastroscopy? [BonPrime Chronic Disease Management with Savings]
Yes, a co-payment of R2,020 applies to gastroscopies and colonoscopies. Strategy reference: ent-2026.
Is depression covered? [BonPrime Chronic Disease Management with Savings]
Yes, depression is covered as an additional chronic condition, with medication cover up to R165 per beneficiary per month. Strategy reference: ent-2026.