2026 Rules Active
2026 Strategy Validated
Type 1 Diabetes: Child Insulin Pump + CGM
Standard Type 1 Diabetes Child Insulin Pump Coverage strategy verified
Covering 2 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
- 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
Do I have to pay upfront for a gastroscopy? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, there is a R5,440 co-payment for day surgery procedures like scopes if you do not use a network day hospital. Strategy reference: ump-2026.
Is my specialist covered in full? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
No, specialists are covered at 100% of the Bonitas Rate. Since many specialists charge above this rate, you may have a shortfall. Strategy reference: ump-2026.
What if I get cancer? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
You have unlimited cover for PMBs, but non-PMB cancer treatment is limited to R280,100 per family with a 20% co-payment. Strategy reference: ump-2026.
Can I go to any hospital? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, the Standard plan gives you access to any private hospital. Strategy reference: ump-2026.
Do I pay for MRI and CT scans? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, there is a R1,860 co-payment per scan event, even if you are in hospital. Strategy reference: ump-2026.
Is dentistry covered? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Basic dentistry is covered at the Bonitas Dental Tariff, but specialized dentistry often requires a co-payment or is subject to managed care protocols. Strategy reference: ump-2026.
What happens if I need a hip replacement? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
You must use a Designated Service Provider (DSP) to avoid a significant R38,560 co-payment. Strategy reference: ump-2026.
Are my chronic meds covered? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, 45 conditions are covered, but you must use a Bonitas Network Pharmacy to avoid a 30% co-payment. Strategy reference: ump-2026.
Is there a limit on how much I can see my GP? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, GP and specialist visits are paid from your overall Day-to-Day limit of R13,980 (Main Member), with a specific sublimit of R3,500 for consultations. Strategy reference: ump-2026.
Do I get cover for emergency room visits? [Standard Type 1 Diabetes Child Insulin Pump Coverage]
Yes, you have a separate benefit for 2 emergency consultations per family at a casualty ward, paid from Risk. Strategy reference: ump-2026.