Bonitas Medical Fund
reviews and complaints

What a wasteful medical aid. I had an accident and was sent home after spending few days in hospital.

A week later I can not wake up from bed and absolutely in tremendous pain. I contacted my doc sent him my scans, he said I need a spinal procedure. The ladies at the surgery began the process only for Bonitas to decline my auth.

Because of it being a pre ex condition. Whereas how can an accident be pre ex.

I personally am absolutely astonished by Bonitas. I am in complete disgust. however at the end of this all they still expect payment for this pathetic services we receive.

My doc submitted reports and motivational letters to support this. as recorded when I was in hospital the last time.

Bonitas underwriting you guys need to catch a wake up call... I will definitely be changing if nothing is done about My situation.

Bonitas changed their benefits on the Primary option , that in 2023 you could visit your own dentist. Only after visiting only dentist in 2024 , and after submitting a claim , and hearing absolutely nothing from 'denis' , not even a statement or email that claim reject , due to BONITAS changing rules without notice , that need to consult a network dentist ! Wtf ?

Not impressed, will be changing medical aids at the end of the year , as this is caniving on bonitas part.

I have sent numerous emails , and call regularly

no-body is assisting me for signing up my membership and it has been more than a week

---------- Forwarded message ---------

From: Julique Becker

Date: Mon, 15 Jan 2024, 07:59

Subject: Fwd: FW: 2024 application form

To:

---------- Forwarded message ---------

From:

Date: Fri, 12 Jan 2024, 14:20

Subject: FW: 2024 application form

To:

Cc: , Nothando Ximba

Mrs AC Jacobs [protected] - ID [protected]

My Mom was with Medshield for 13 years and now Boncap charges late joiner fees because my Mom was not with a Medical aid for 43 years. I have never heard of this. In my experience I know that if you move from one medical aid to anther it doesn’t matter how long you have been with the previous medical aid late joiner fees are not charged. I personally have moved from Discovery to Bonitas a few years ago and they neer charged me late joiner fees.

My name is Michelle Horn (daugther) [protected]

On 21 November 2022 I took the the test as I have been required to submit test every six month and Im registered for chronic medication but it came to my surprised to hear that Bonitas did not pay as my funds were laps

How can the funds not available while I know very well that Im registered with AFA and covered fully for the costs.

I tried to enquire about it including they just infom me that the doctor couldn’t claim with the correct codes.

But the doctor did not agree because the same codes he used are the same codes the doctor has used to claim.

I was sent an email from Bonitas to advise that my son who is still studying is still on the medical aid as a student. Thereafter I get another letter advise he has been removed from the medical altogether and the initial letter was sent in error. They requested proof he was studying but then rejected that he can be put on as a student and we must pay full price for him which we agreed. However he was not on the medical since they removed him and only towards the latter part of last month did they confirm he can be back on. However they now say we owe R5000 for him when its not possible as he was removed from the medical aid by Bonitas. Now they have not deducted any premiums for my us this month. Please help asap

[protected] Member number

Good day my 19-year-old son has an anterior medical meniscus tear – radiology evidence was sent due to a secondary code provided by the rooms; case was declined these effects his livelihood and he has a functional impairment. He is unable to walk at the age of 19. He also has a complicated popliteal cyst and a patellar effusion.

He needs to have a posterior repair to be done to help preserve the meniscus and to minimize the risk of developing arthritis. A radial meniscus tear in an adult doesn’t usually heal or repair itself. The tear can thin and irritate the cartilage on the end of the femur and tibia.

Failure to do this repair will result in permanent damage! who is going to be held accountable.?

Bonitas is refusing to cover the prosthesis., what happens in the scenario due to negligence he will end up be needing a knee replacement?

This is unacceptable from any medical aid. I will submit a complaint to CMS and a media complaint.

Eleonora was born on the 25.02.23, on our medical aid (we have 3 other kids ALL BORN ON THE MEDICAL AID). I would like to contest the feedback received from Bonitas regarding the claim for Eleonora ‘s GP consultation 30.04.23.

I have applied to register her on our medical aid at the beginning of April, it is NOT our responsibility if Bonitas took almost a month to register her. On Sunday, the 30th April, my daughter was so ill that I first rushed to the ER, only to be told they cannot find her on our Medical Aid, leaving me to HAVE to see a GP rather, which did not pick up immediately the severity of her illness. That all because I was unable to have her admitted and receive the necessary care because of Bonitas NEGLIGENCE.

She landed up having severe pneumonia while waiting for Bonitas to attend to their work.

Good day

I've been trying to obtain authorisation for PMB's for patients and do not get any authorisation back. They only send us query numbers for the application. e.g.

1st patient - Apply for authorisation on 10/01/2023 - Query nr 100123QGNN9N and 080223QHYXWY.

2nd patient - Apply for auth on 12/01/2023 - Query nr 120123QGSTB4 and again Query nr 08/0223QHYXX2.

3rd patient - Query nr's 120123QGSTLM and 080223QHYXXT.

4th patient - Query nr's 120123QGT0DB, and 080223QHYXXX.

5th Patient - Query nr's NR'S 160123QGXJ48 and 080223QHYY85.

6th Patient - Query nr's 020223qhpmy1 and 080223qhyy5f.

I also followed it up on 26/01/2023 - QUERY NR 260123QHDRDP, telephonically as well as on 20/02/2023 - Query nr 200223QJHK28.

Today 02/03/2023 I tried to phone the contact centre again for feedback. They put me through from the one person to another three times. I was cut off twice. Still did not receive any help. How is it possible to wait for PMB authorisation from January and still outstanding today? I am also extremely upset about the poor service I received from the contact centre. This is absolutely unacceptable. We've being trying everything from our side to help the patients but with no help from Bonitas.

Ive been emailing boncap for a month now as they put me in the incorrect income bracket, the numbers I try call don't even go through. The service is appalling! Still have no response and will be posting on hello peter soon if this is not resolved. They need to refund me the amounts they over charged. I honestly wish I never got this plan as the service or lack thereof is disgraceful! I asked for contact numbers and a manger to call me back, but they clearly don't care. You can even see how many cases are unresolved.

After many calls back and forth, I am quite frustrated and fed up to the point that I want to move to a different medical aid.

My husband was admitted to Life Wilgers Hospital Emergency Room on the 25/12/2022. Due to my husbands alarmingly high fever, the treating doctor requested blood tests in order to make her diagnosis. The attending doctors' bill which falls under Wilgers Trauma Group was paid but (Code 7062) but the blood tests done on the day by the hospitals pathology department (PathCare) was rejected. (8456/671) The claims department advised me that the doctor is not on the networks and therefor she cannot request blood tests. This blows my mind as anyone knows that you cannot decide which doctor assists you in an Emergency room ? Should all ER doctors not be on the network since Life Wilgers is a Network Hospital. The doctor requested that my husband return to the ER on the 28/12/2022 (follow-up) for blood tests to see if the antibiotics she prescribed was affective and if his infection count has decreased thus another claim on the 28th.

I urgently want feedback and the claim to be reviewed, as this does not make ANY sense at all and the call centre cannot seem explain why a network hospital ER doctor claim was paid but not the blood tests the doctor did ?

Please see below the account that was rejected and the proof of payment where we privately settled the account.

In the event of an emergency which hospital should I visit as Wilgers appears to be a network hospital BUT the doctors in the ER is not ? How do I have control over this ? It is an emergency situation ?

This is the second claim I have had trouble with. Thinking of calling Discovery because this is absolutely bonkers.

I added a new dependant (my mother) in January this year. Seeing the 2023 Brochure an adult dependant was R1910.To my surprise when I get paid they deducted R3633 plus R7131. Without notifying me of their changes. I called them on the 15th and I was told to sort it out with my employer. I sent an email and and a day later I was told there was a R1555 penalty for late submission (which I still don't understand) and there was a R5500 for my mother. Why did they send me the brochure with the wrong amounts? I WAS MISINFORMED BY BONITAS.

good day

Medical aid number [protected]

I added my husband on my medical aid effective 01.01.2023, he was on Discovery medical until the 31.12.2022.

I was never told that there would be a waiting period of 3 months- i have contacted them and was told no there will be no waiting period as he is going from 1 medical to another!

Now i get told a different story, because he is on chronic meds for asthma he will only be covered effective 01.04.2023 but i must still pay contributions!

I am totally disgusted with Bonitas, after being on Bonitas for 8 years.

Bonitas dictate that if a member doesn’t use PharmacyDirect, their sole provider, then a co-payment will apply. This co-payment can easily go into thousands of Rands when one is on chronic medication.

PharmacyDirect is owned and operated by AfroCentric and is an online pharmacy. This means that one can only correspond with them via virtual and telephonic exchanges and unfortunately, they are coming up short in service delivery.

It’s been over 2 weeks that I’m going without vital chronic medication due to their failure to deliver. Sending queries certainly has not helped speed up their service and there’s no sense of urgency.

I’m afraid that the only route would be a complaint to the Council of Medical Schemes if this continues.

All I can hope is that this doesn’t end in my premature death due to not being able to afford the chronic medication co-payment as that would certainly give rise to a wrongful death claim from my family.

How is that [censored]ing possible?  This is ridiculous! Up with a R1100 and I still have to pay for my medication because it's not covered by the medical!  I have to pay cash for specialists!  I pay cash for follow up blood tests!

I pay cash for most dentist procedures as this medical is actually just useless to meI receive a basic salary only.  I had a handful of savings I had to dive into because I'm barely getting through the month on what I earn now!

I will pay this amount if the medical fully covers the following for the entire year:

Tetralysal - R400 per month

Nordette - have to pay like R700 in every year.

EltroxinVitamins (currently using folic acid, vitamin e, Novavit, essential) Costs me +-R300pm

And specialists - Paid 2 visits that cost me R2000 Specific face washes and creams recommended by specialist for my rosacea that also costs me like R2000per month

This is really unexceptable!  I cannot afford this.  I will have to start looking else where

What did I actually use of the R18084 I spent on Bonitas this year? Probably nothing and now they expect me to pay R31200? What for?

How do you expect people to survive?

What about food, water, electricity (which we have anyway none of but is still expected to pay)

Please reconsider!

Bonitas membership no: [protected]. L Nel

Since joining the Bonitas BonEssential Select hospital plan on 1 August 2021 I noticed a late join penalty of 25% being applied to my monthly membership fee. This despite the official Bonita's membership policy clearly stating a penalty of only 0,5% for not being a member of an approved fund for a period of up to 5 years.

As background I have always since age 28 belonged to approved medical funds only with exception of a 10 month interruption period from 1 October 2021 until 31 July 2022 with the last fund that I belonged to being Momentum Health. In addition my certificate of membership of Momentum Health that was submitted during the Bonitas membership application process clearly confirms that NO late joining fees were ever applied by Momentum.

I have subsequently attempted to explain to Bonitas though official written communication without success, that Momentum Health as my last or prior medical fund would have raised late joining penalties if there were any membership interruption prior to joining them.

However Bonitas still insists on details of all prior approved medical funds to which I belonged as well as dates of membership which unfortunately I cannot recall or retrieve over such a long time spanning my entire working life, being 67 years of age currently. This also complicated by the fact that some prior funds do not exist anymore and that old archived membership records at funds that still do exist currently, are not comprehensive or complete.

My wife was diagnosed with colon cancer.

I then had to see an Oncologist and enquired about a list of Oncologists from Bonitas who I can use to exclude a copayment. For three weeks, no response. Eventually I was told that the pathologist which was suggested by the surgeon was not part of the oncology network. The Oncologist confirmed that they were registered with SAOC as per the requirement from Bonitas. Again, a long story short, I requested a list of oncologists from Bonitas. Eventually they sent me a spreadsheet indicating that the Oncologist I used were not registered. When I filtered on their spreadsheet, the oncologist was listed as registered. A lengthy telephone call with the oncologist division, being put on hold three times for them to confirm with their superviser who indicated that the oncologist was not registered, eventually discovered that they were registered. I was given a reference number to submit to claims to reprocess the claim. I then received a letter from Bonitas indicating the scheme rules with no explanation. My query is that I was aware if I don't use a network oncologist that I am liable for a copayment, but don't expect to pay a copayment if the oncologist is registered. I still have no confirmation and not sure with further visits to the Oncologist whether I must pay a copayment or not. I am simply being ignored. All these complaints were within a period of almost four months and find the staff at Bonitas very incompetent and no care towards their members. I have requested to speak to a senior person, but my requests are now being ignored. I pay a subscription to the medical aid for their services, but I am always in between the medical aid and the service provider even though I am not aware of medical terms or codes or whatever is required to ensure that the bills are paid. An exceptional medical aid with staff who is incompetent or don't care less for members

I have resigned from my previous employer on the 27th of June. I have sent numerous emails, which they dont respond to at all. Memberhip is a requirement at my new employer and I am still struggling to get my Bonitas memberhip terminated. Every time I speak to a consultant, they have a different excuse. First they told me that there is an arrears amount on my contributions, then I was told that there is a 30 day waiting period, then I was told that my previous employer did not send the request through from their side, today I was told that now there is a 60 days waiting period. So which is it? Terrible service, never join Bonitas, they do not value their members.

On 2nd of July 2022 I received Heart Arrythmia emergency Treatment at Busamed Gateway Emergency Centre, from the Hospital doctor who did an ECG before and after the treatment, as well as an intravenous infusion with medication to slow the heart rate down. The claim for treatment from the Emergency Centre was rejected by Bonitas ! I am very dissapointed and will likely cancel my membership as most of our claims are rejected by Bonitas.

Am highly disappointed with pharmacy direct, and I would like to know if is there any pharmacy that Bonita will allow me to personally fetch my medication personally, am on chronic medication, after my 6mnths check up from the Dr on the 11th of April I sent pharmacy direct my prescription but till today I have received my pills and it's been 3 days without taking my pills as there are finished, which means am defaulting as I had sent my prescription on time, please help is there a way I can take my pills at a pharmacy by myself... Please help

Sbahle Hlophe

[protected]

[protected]

HI,

My query/request goes back to last year August/September 2021.

I have been asking Bonita's to change the main member since last year August 2021 and till to date I haven't been assisted. its always been the Brokers fault when you follow up and still nothing changes.

At the moment I am not covered because I was suppose to finalize my application with Bonita's for the 1st of January 2022 and still haven't had anything from Bonita's.

I have sent numerous emails only to get a reference query number and called don't know how may times and again only to be told that my query is with the broker.

Now the worst is each time my request is not resolved I have to complete another form because of the inception date having to be changed on the form for the following month, what a nightmare! I have never ever receive such a bad service.

This broker thing is creating lot of problems for clients, Bonitas should deal with their client themselves from start to finish.