2026 Rules Active
2026 Strategy Validated
Traditional Day-to-Day with Sublimits
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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]
Common Questions
What is the 2026 monthly premium for Bonitas Primary? [Primary Family Day-to-Day Moderate Coverage]
The main member contribution for 2026 is R3,588 per month. Strategy reference: ate-2026.
Do I have to use specific hospitals on Bonitas Primary? [Primary Family Day-to-Day Moderate Coverage]
Yes, this is a network plan. You must use hospitals on the Bonitas Primary network to avoid a 30% co-payment. Strategy reference: ate-2026.
Is there a limit on cancer treatment? [Primary Family Day-to-Day Moderate Coverage]
Yes, non-PMB cancer treatment is limited to R224,100 per family. PMB cancer conditions are covered without limit. Strategy reference: ate-2026.
Are gastroscopies and colonoscopies covered in full? [Primary Family Day-to-Day Moderate Coverage]
No, there is a R2,020 co-payment for gastroscopies and colonoscopies performed in hospital. Strategy reference: ate-2026.
Does the plan cover MRI scans? [Primary Family Day-to-Day Moderate Coverage]
Yes, but there is a limit of R15,960 per family and a co-payment of R2,240 per scan. Strategy reference: ate-2026.
What is the day-to-day limit for a single member? [Primary Family Day-to-Day Moderate Coverage]
For a main member, the overall day-to-day limit is R5,540 per year. Strategy reference: ate-2026.
Is dentistry covered? [Primary Family Day-to-Day Moderate Coverage]
Yes, basic dentistry is covered at 75% of the Bonitas Dental Tariff, subject to the Bonitas Dental Management Programme. Strategy reference: ate-2026.
Are internal prostheses like hip replacements covered? [Primary Family Day-to-Day Moderate Coverage]
Internal prostheses are covered for PMB conditions only. There is no benefit for non-PMB prostheses. Strategy reference: ate-2026.
How many chronic conditions are covered? [Primary Family Day-to-Day Moderate Coverage]
The plan covers 28 chronic conditions, including the 27 PMBs plus depression. Strategy reference: ate-2026.
Is there a co-payment for cataract surgery? [Primary Family Day-to-Day Moderate Coverage]
Yes, you must use a Designated Service Provider (DSP) to avoid a R8,400 co-payment. Strategy reference: ate-2026.
Primary Family Day-to-Day Moderate Coverage strategy verified
Covering 3 family members
2026 rates applied