I still remember the day my cousin phoned me, completely stressed out. She had just been to the doctor with her toddler, and the consultation plus the medication set her back nearly a quarter of her monthly salary. Her frustration wasn’t new—medical aid in South Africa has long been viewed as something only the middle to upper-middle class can afford. The rest are often left to navigate public hospitals, where queues stretch on for hours and even basic care can feel like a lottery.
That’s the backdrop against which Bonitas launched their BonStart Plan. At first glance, it seems like a fresh solution, a medical aid option designed for younger, tech-comfortable people who may not yet be earning big salaries but want a safety net. The twist? It’s digital-first. That phrase sounds futuristic, almost like medical aid caught up with the smartphone age. But does it actually solve the access and affordability problem, or is it just a rebranding exercise with an app attached?
Let’s unpack this.
What BonStart Actually Offers
BonStart is positioned as an entry-level medical aid product within the Bonitas family. It’s not a hospital plan in the traditional sense, but rather a hybrid option that leans heavily on digital health tools. Members are encouraged, and in many cases expected, to engage with healthcare services online first. Virtual consultations with doctors and nurses are the starting point, with in-person care available when needed.
The plan covers everyday essentials like GP consultations, some chronic medication, maternity benefits, and hospitalisation. But what stands out isn’t just the list of benefits—it’s how you access them. Think telemedicine, online scripts, and digital claims submissions. The idea is to reduce costs by cutting out unnecessary in-person consultations, streamlining admin, and giving members faster access to healthcare professionals.
In theory, that makes sense. If you wake up with a sore throat or a skin rash, why take half a day off work to sit in a waiting room when you could hop on a video call with a doctor in fifteen minutes? BonStart is betting that South Africans, particularly younger ones, will embrace that model.
The Appeal of Digital-First
There’s no denying it: younger South Africans are already glued to their phones. Banking, food delivery, dating—so much of life is lived through an app. Health, though, has lagged behind. Partly because of regulation, partly because many people simply feel safer seeing a doctor face to face. Bonitas seems to be nudging us toward a shift.
A digital-first model appeals for several reasons:
-
Convenience. No need to drive across town or sit in traffic for a five-minute script renewal.
-
Affordability. Online consultations tend to cost less, and those savings may filter down to lower premiums.
-
Accessibility. South Africans in smaller towns, who may struggle to find specialists nearby, can theoretically access expertise from anywhere.
But “theoretically” is the keyword here. For this to work, you need decent internet, a working smartphone, and enough data. That’s where the cracks in the shiny digital-first promise start to show.
The Digital Divide Dilemma
It’s easy to imagine BonStart working perfectly for a 27-year-old marketing professional in Johannesburg with fibre at home and unlimited WiFi at work. But what about someone in Limpopo or the Eastern Cape, where mobile reception can be patchy, and data costs are a real burden?
South Africa’s digital divide is no secret. Stats SA has pointed out that millions still don’t have reliable internet access, and data prices, while improving, are hardly cheap. That makes me wonder whether BonStart is inadvertently designed for the already-connected middle class, leaving out the very people who often need affordable healthcare the most.
Even among those with access, there’s the human factor. My mother, for instance, still gets nervous paying bills online. Asking her to diagnose a medical issue through an app? That’s a stretch. Digital-first, while attractive on paper, may alienate older or less tech-savvy members, even though medical aid is often most needed by those groups.
Affordability: A Step Forward or Just Another Marketing Spin?
Let’s talk numbers. BonStart is marketed as an affordable entry-level plan. It’s cheaper than many comprehensive medical aids and does provide a fairly broad set of benefits. But here’s the catch—affordability is relative. For someone earning R10,000 a month, a medical aid premium of around R1,500 (give or take, depending on the option) is still significant.
There’s also the subtle worry that “digital-first” is partly a cost-cutting exercise for the medical aid scheme. Virtual consultations reduce overheads for doctors and insurers. But do those savings translate into better value for members, or just higher margins for the scheme? Some may argue that digital-first plans work best for healthier, younger members who don’t claim much—almost like a filtering mechanism to attract low-risk individuals. That isn’t necessarily bad, but it does raise questions about inclusivity.
A Cultural Shift in Healthcare
One thing I find fascinating is how BonStart isn’t just selling a product; it’s nudging cultural behaviour. South Africans have long associated quality healthcare with walking into a doctor’s room, having your vitals checked, and walking out with a handwritten script. BonStart is subtly suggesting that healthcare can live on your screen, and that trust in a “real” doctor doesn’t require physical presence.
Will people buy into that? Perhaps. But trust in healthcare is deeply personal, and in a country where many already feel let down by both public and private systems, digital consultations may initially feel impersonal, even experimental. Still, younger members who grew up Facetiming friends may see it differently—less like a compromise and more like an upgrade.
My Own Experience with Digital Healthcare
During the pandemic, I tried my first telehealth consultation. I was skeptical. How could a doctor possibly diagnose me without poking, prodding, or at least listening to my chest with a stethoscope? Yet, for what I needed—a simple script renewal—it worked seamlessly. Ten minutes, no waiting room, no R500 consultation fee. That experience shifted my perspective.
But I also remember a different occasion when a family member tried a virtual consult for stomach pain. The doctor eventually insisted she come in for tests, which meant she paid for both the digital and the in-person consult. That double cost left a sour taste, and it reminded me that digital healthcare is not always a replacement but often a triage step.
The Bigger Picture: Is This the Future?
So, is BonStart pointing to the future of medical aid in South Africa? Possibly. There’s a growing global trend of digital-first health solutions, from the UK’s NHS online GP services to the US’s explosion of telehealth apps. South Africa is unlikely to be left behind.
But the rollout here needs careful thought. Without addressing the digital divide, these plans risk creating a two-tier system: those who can afford data and devices enjoy streamlined healthcare, while the rest remain stuck with long queues and limited options.
At the same time, digital-first plans like BonStart may push the industry in a direction that forces traditional schemes to modernise. If younger members flock to cheaper, app-based models, older schemes will need to adapt or risk becoming obsolete.
A Balanced Perspective
BonStart isn’t perfect. It may exclude some groups, and it may be better suited to young professionals than families or older members. Yet, it does represent a step toward more accessible, tech-enabled healthcare. The question is whether it’s a stepping stone or the final destination.
For now, I’d say BonStart feels like the start of an experiment. It’s a product that works well for a certain demographic—urban, tech-savvy, relatively healthy. Whether it can scale beyond that will depend on South Africa’s broader ability to make digital access universal.
Final Thoughts
When I think back to my cousin, who nearly cried over that GP bill, I can’t help but feel a product like BonStart would appeal to her. Affordable (at least compared to comprehensive cover), simple to access, and less intimidating than the traditional medical aid jargon. But I also think of my mother, who’d sooner stand in a two-hour clinic queue than download an app.
That’s the paradox of digital-first medical aid in South Africa: it may be the future, but only if the present catches up first.