2026 Rules Active
2026 Strategy Validated
Active Family: Sports Physiotherapy Benefit
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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]
- 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
Are joint replacements covered? [BonStart Plus Family Sports Injury Physiotherapy]
No, joint replacement surgery is listed under 'Surgical Procedures That Are Not Covered' and is excluded. Strategy reference: ury-2026.
Can I go to any private hospital? [BonStart Plus Family Sports Injury Physiotherapy]
No, you must use a hospital on the applicable network. Using a non-network hospital incurs a R12,680 co-payment. Strategy reference: ury-2026.
Is there a co-payment for admission at a network hospital? [BonStart Plus Family Sports Injury Physiotherapy]
Yes, there is a R1,240 co-payment per admission at a network hospital, except for PMB emergencies. Strategy reference: ury-2026.
Are gastroscopies and colonoscopies covered? [BonStart Plus Family Sports Injury Physiotherapy]
No, gastroscopies, colonoscopies, and all other endoscopies are explicitly excluded from cover. Strategy reference: ury-2026.
Do I need a referral to see a specialist? [BonStart Plus Family Sports Injury Physiotherapy]
Yes, you must get a referral from your network GP. Consultations are limited to 2 visits per family. Strategy reference: ury-2026.
Is there a limit for chronic depression medication? [BonStart Plus Family Sports Injury Physiotherapy]
Yes, depression is covered as an additional condition, but medication is limited to R165 per beneficiary per month. Strategy reference: ury-2026.
Does the plan cover MRI scans? [BonStart Plus Family Sports Injury Physiotherapy]
Yes, but there is a R14,090 family limit and a R2,800 co-payment per scan event, unless it is a PMB. Strategy reference: ury-2026.
Are maternity scans covered? [BonStart Plus Family Sports Injury Physiotherapy]
Yes, BonStart Plus covers two 2D ultrasound scans during pregnancy. Strategy reference: ury-2026.
How many GP visits do I get? [BonStart Plus Family Sports Injury Physiotherapy]
You get unlimited network GP consultations, but authorisation is required after the 10th visit. Strategy reference: ury-2026.
What is the penalty for using a non-network day hospital? [BonStart Plus Family Sports Injury Physiotherapy]
If you do not use a network day hospital for selected procedures, you will be liable for a R12,680 co-payment. Strategy reference: ury-2026.
BonStart Plus Family Sports Injury Physiotherapy strategy verified
Covering 4 family members
2026 rates applied