Bonitas Medical Fund
reviews and complaints

On 11th December 2019 my wife was sent for blood tests by Dr Smedema her cardiologist.
These tests fall under her PMB conditions - She has had stents put in her heart and was later rushed into hospital three years ago when the stents got blocked.
Bonitas paid 1162.92 out of day to day savings and there is still a balance of 1724.18 outstanding.
The account should have been paid in full as a PMB.
Pathcare have resubmitted the account today.
Exactly the same thing happened in 2018 and Bonitas finally reversed it in March 2019 but I never got fully reimbursed for the Day to Day savings that they "stole" from me.
My details are Lorimer Frazer Bonitas number [protected]
My wife is Delise Ann Frazer

Bonitas is costing me because I have been calling concerning this ref number 181019QP3KJH and I still cant be assisted, I need to claim on my gap cover but now the problem is that the statement from Bonitas and from the Dr does not match, Bonitas told me that Dr sent the figures like that and now my gap cover won't pay, I spoke to the Dr and they sent the documents to Bonitas for them to correct the statement and they promised that it will take 10 working days, today it is the 15th day and still no response, I called yeaterday and I spoke to Tebogo who told me that there is no feedback on the system he will have to check and get back to me he didnt bother calling me back, today I call again and I spoke to Olebeng who made me hold for a long time until I ran out of Airtime, all I need is for Bonitas ti confirm that the statement from the Dr is correct either on the statement or a letter so that I can send it to Sanlam.

Good day,
I wish to bring to your attention, poor service-delivery of Pharmacy Direct. I have been utilising PharmacyDirect for approximately three years to supply my chronic medication. However they always deliver it late. I am a hypertension patient and require my medication to control my condition but because they deliver my medication late, I sometimes cannot take my medication as prescibed.

Kindly investigate the poor service delivery from Pharmacy Direct and consider using another service provider.

My medication claim was not paid because Bonitas says I needed a script. The pharmacy has stated that this medications scheduling has dropped over three months ago and you no longer need a script. Why has the system on Bonitas not been updated? I then got a script which medical aid now wont pay for the script because they say I need a referral letter to go to that pediatrician, even though I did not go to the pediatrician got a script for the meds I needed.

I want to know why Bonitas shows you need a script and pharmacy shows you do not. And I want my claims to be paid out.

I have been on the phone for 2 hours. Transferred to 4 different people. They now tell me to go Walk in center and they say the walk in center will tell me the same story? So why send me there? I' wanting someone to contact me to resolve this matter immediately.
My contact info: gaynor.[protected]@capetown.gov.za / [protected]

I have been on the line with Bonitas back and forth with agents from 9 am yesterday. I have been receiving feedback from agents that is standard procedure for the entire day.

I am now highly infuriated-imagine as a patient having to deal with not getting authorization despite stressing to agent upon agent how urgent it is, only to then have an absolutely rude call Centre agent by the name of Stefan.

I had requested to him to speak to his superior because I finally tired of speaking to agents and I needed the mnunerous matters to be addressed - instead of being patient and understanding to my needs as a patient and client, he was abrupt and insensitive.

I really am not impressed by Bonitas lack of care to clients. I had transferred from another medical aid thinking Bonitas would be better for me, however it appears that on my first encounter of requiring medical treatment Bonitas and its agents are looking for ways to avoid situations and approving authorizations based on being a new joiner.

Good Day,

Membership number: [protected]

I am getting fed up of this up n down with calls and emails.

I was told by one of your consultants that the 1st month for baby is free and the new installments will be effective from the new month which is July 2019.

Why is it now effective from registration 1 June 2019 who is incompetent... due to this my benefits is suspended.

I feel like cancelling my plan and take my business somewhere else where I can get customer service cause clearly Bonitas don't know what customer service is.

I am really getting Gatvol of this kak there no better way of saying it and yet use are quick to close queries which was never resolved.

I'm spending lots of money on calls daily and emails with various queries and no one assist all you get is automated emails and closure emails.

After joining Bonitas, I noticed that the first month ( February) was not debited. I phoned and emailed asking when the debit order will go off and was told on the 1st of March. No debit order was taken off in Feb as it was past your debit order date when I joined. I am now told My medical aid is suspended!
This is ridiculous! I cannot afford a double debit, why must I now be suspended because of an error you made? You are now trying to double debit me each month and wonder why only one payment goes through!

I have phoned customer care only to be told there's nothing they can do unless I pay up! Your customer service department totally suck! they are rude and unhelpful. I have never experienced service like this from any other medical aid.

Well I cannot afford another R3500 just to pay extra on top of my normal payments!

If you cant sort this out, I will cxl my debit order, reverse it and go to another medical aid.

Please respond ASAP

Hi please advise I have to pay a co payment of r274 of a claim of r1087 on chronic medication bonitas I pay over r6000 on my medical aid a month now I have to pay more because I dont use pharmacy direct this is surely against the law as I have a right to use a pharmacy of my choice I live in phalaborwa I dont want to use pharmacy direct as they do not deliver medication on time or in my area I need advice please kind regards farah jane krohn email [protected]@lancaster. Za.net cell no [protected]

I am a member with Bonitas with membership number [protected] and added three beneficiaries from 1 September.

A general waiting period of three months was imposed on my son Marius Badenhorst. Both my financial advisor and myself engaged with customer service as well as underwriting several times to find the reason for the waiting period and ask for removal since we don't feel it is valid and fair and against the medical aid nation act.

1. Marius was on a medical aid for longer than 24 months and moved without an interruption of more than 90 days.
2. The move was a forced move due to employer contributions being stopped followed by retrenchment on my husband's side. No general waiting period should therefore apply since this was forced.
3. A minor procedure was performed on Marius in April 2018 where his foreskin was stretched under moderate anaesthesia. He was admitted to hospital for a few hours for this procedure it was once-off and completed successfully and was not a medical condition that continued. Underwriting first indicated that this was the reason for the waiting period but then waived the condition and still kept the waiting period.

We are still struggling to get this resolved and my advisor escalated the matter to CMS and we are applying with another medical aid since Bonitas did not properly provide feedback or resolve this matter.

Ref numbers for enquiries lodged:
MI667064513
MI670753446
MI670532900
MI667406828
060918Q01HM9
140918Q0J7FY
130918Q0FG19
170918Q0KX9G

After the passing of the main member on Bonitas medical aid passed away they cancelled the medical aid but still subtracted fees. On a statement 29/03/2012 they stated that they are aware of the R12 000 credit. even after we got a lawyer and admitting they took the money wrongly and that they will pay it back they have still to pay anything. this is pathetic. a Medical aid that cares nothing for its members like this should be shut down.

Medical plan Bonfit
Medical aid number was [protected]

Received preauthourised approval before procedure to have Bonitas back track and only pay less than half. I am on the most expensive Comprehensive package and they have been nothing short of useless and in my view unethical. I don't know how you sleep at night, [censored].

My chronic medication has only been covered for half the amount of months and they do their utmost to not pay. All your marketing [censored] is a load of lies and you have no cocern for your customers. Get bent, my family and whole company will be moving ASAP.

Patient (REF [protected]- [protected]) was in hospital 01/04/2018-06/04/2018 yet bonitas paid two Doctors with the Day-to-day-benefits funds instead of hospitalisation for 03-06/04/2018. All the required information was sent to bonitas but even now in August this matter is not yet resolved. I have to pay the specialists and buy medications cash all because of the negligence of Bonitas. This is totally unacceptable!

I want all the funds used to pay these two doctors to be paid back to the day-to-day-benefits funds.

Claim submitted on the 28/06/2018

9 Days later after submitting the claim, i called to find out whether or not they had received my claim, I was then told that claim would be resolved within 7-14 working days. On the 14th day i called again there i was told my claim had been rejected because i did not submit a referral letter from the Dr., On the same day i then emailed the outstanding Referral letter. Today being the 24/07/2018, I called yet again because there was no consistent communication from them. I was now told that i need to wait another couple of days.

I am extremely disgusted with the level of unprofessional ism i am receiving from them. They do not bother to communicate anything with me being the client, instead i am the one having to follow them around, calling or emailing just to know what the hold up may be but even then i can never be told the correct and precises information about my claim. This has now also become an inconvenience to my financials because i know have to continuously fit the bill that my medical-aid had to pay...

REF:[protected]_[protected]]
I have a debit order dispute that I have submitted forms for on the 27 march2018 been calling to make a follow up no luck I understand that the turn around time is 30 working days, NOW I'm getting another email saying that I need to send new debit order dispute forms as they can only assist me once that is done is that even fair though? This is very unprofessional I cannot do this back and fourth with you guys because it means if I send new forms its now going to be another 30 working days that I have to wait for which means 60 working days. i asked to get a reply on the 27 of April regarding my dispute as I send other forms again. Let me know if this will be possible for you to reverse my money that was deducted or I should change the bank as the service is very poor. You have such incompetent consultants my money you need to make it happen that me as the client I am happy because right now I'm very much unhappy with your service . I did not get an reply from you guys kindly get back to me

I have recently been retrenched. Mr Shane Moses came to our place of employment (Karbochem Newcastle)a month ago. All the Bonitas members filled in the forms to either discontinue membership or to continue in a private capacity. I elected to continue in a private capacity. My membership has subsequently been terminated. Mr Moses is unable to answer as to why the documentation was not sent directly to you and he seems to be unable to find the necessary forms that were submitted. Last week my grand daughter was admitted to hospital with swine flu. If these accounts have been rejected by Bonitas because our membership was terminated then I will hold Mr Moses personally responsible for the medical bills. I am most dissatisfied with your broker's service and wish to lodge a formal complaint. I have subsequently resubmitted the documentation directly to Bonitas and am hoping this matter will be resolved immediately.
Mr D A Headley [protected]

On 14 May 2018 I saw a GP, as my left airways felt permanently blocked and due to this I have pain in the left side of my face. The GP was unable to diagnose me and therefore referred me to an ENT specialist (Referral Number [protected]), for further investigation. I booked my visit to the ENT Specialist for 24 May 2018, as the referral was valid for 2 months.

On 24 May 2018 ENT Specialist sent me for a CT Scan (which I paid myself) and he found that I had a Deviated Septum to the left. The ENT Specialist then booked surgery for Monday 28 May 2018. On the same day, after my appointment I called the medical aid to apply for authorization which was immediately captured.

On Friday 25 May I received an email from the medical aid, declining the authorization due to a possible "non disclosure of a pre-existing condition" and they requested a clinical report from the treating doctor, which the doctor sent back to them, including a copy of the CT scan report.

On 28 May 2018 (surgery scheduled date) I was called by Ilhaam Jakoet at the pre-authorization department, informing me that the authorization has again been declined, and this time due to a 3 month waiting period imposed. I ask her if the doctor's clinical report was received, and she couldn't confirm and asked me to send it to her direct email address and that she would submit it back to the underwriters.

On 29 May 2018 Ilhaam calls again and tells me that the authorization came back from the underwriters, once again been declined due to 3 month waiting period. I queried the waiting period as I did not have a waiting period when I joined nor does it stipulate it on my membership certificate. (not knowing that the waiting period was imposed only on 28 May 2018). Ilhaam, very unprofessional tells me that even though I pay medical every month, if I should get into an accident, I wont be covered. By this time I am furious with the response. She sends me an email with the authorization being declined and the reason is…"please contact our contact centre for help with cancelling your membership". UNPROFESSIONAL to say the least.

I then contacted Bonitas Connect where I am told by the agent that the real reason for the auth being declined is that the GP and ENT specialist diagnosed me with 2 different conditions which coincide with one another and because I used nasal decongestants. What Bonitas fail to see is that the GP referred me to the ENT specialist to be diagnosed (they provided the GP with a specialist referral number). So how could this have been a preexisting condition if teh GP never treated me for any nasal conditions neither prescribed medication. The nasal decongestants I use is to try and open the airways, obviously because I am not a doctor and cannot diagnose myself but I can self medicate myself.

My surgery has since been rescheduled for today 31 May 2018 and admission time is 8.30am and I am still fighting with Bonitas and their incompetent staff, who struggles to understand logic.

On 30 May 2018 I called their call centre once again and insisted to speak to their teamleader. They put me through a guy called Zander who happens to be the team leader and he asks me to email him directly and I send through all documents and a written report. Hours later I call and he conveniently is not around for hours to answer my call. When I eventually spoke to another agent I was informed that the team leader received the email but not the attachments, which was an utter lie as both emails sent had all docs attached. Later the afternoon I called the call centre again requesting to speak to the team leader who was very abrupt and lied to me over and over trying to cover up his laziness and unprofessionalism.

I am utterly disgusted with the service Bonitas have rendered over this last few days. I was on Bonitas medical aid for 7 years and cannot understand how the level of their service has dropped to zero and treating people as if they are doing them a favour. People pay 1000s for medical aid and this is the kind of service we are being rendered.

I request a full investigation into the matter and need urgent feedback.

I have a 6 year old daughter who is physically disabled. She was diagnosed with Hydrocephalus at 5 month due to brain damage caused by CFS she was also diagnosed with Cerebellum Palsy and Epilepsy. In 2016 my shortfall for Bonitas was plus 60 000 on which some of the claims it's not even clear why they were not paid. This short fall is for one person for all the operations that were needed to save her life. Last year Bonita's did not pay for her splints as much as they are still on PMB approved list but they don't pay without a valid reason. Each time I call a new consultants is investigating and escalates the query but there is no payment. The service date for this claim was the 15/06/2017. Another query where not I've been summoned for non payment and the medical aid is not pay is for anesthetic for MRI done in hospital on the 9/05/2017 in hospital. Each consultant will perform some short analysis and conclude with a different resolution mostly does not even make sense. Kindly assist to resolve this issue we are paying but we don't get the help we deserve. Membership number [protected].

I have been a member of Bonitas Medical Aid for 5 years but this year will definitely be the last year. Your service had deteriorated so and nowadays you are to scared even to go to the hospital for a procedure. Nothing in-hospital gets paid except the hospital self. I am still sitting with all the pathology accounts, physiotherapist accounts (all of it been handed over). Was send numerous time to the claims department and still not paid.

To whom it may concern 

I'm very much disappointed with the level of service the Bonitas and thier employees have given me. 

I requested for a hospital authorisation on Thursday last week the 22/03/2018 for a procedure that will be tomorrow 27/03/2018 at 7h30am. I was sent from pillar to post and no one was coming back to me telling me if it is approved or declined. I was request to send a photo of my scar which was sent at 12h00pm as per the email. I was told it was escalated to medical assessors. I am sure everyone dealing with this request knew that the procedure is at 7h30am the 27th of March and I was promised that I would have my response before the end of business. After doing several follow ups I still had not have my response and when I called again at just before 5pm I spoke to an agent by the name of Katlego who was supposedly escalating the matter to the supervisor, who was supposedly getting in touch with the medical assessors responsible for my request. At the exactly 17H00pm the agent that I was dealing with cut the call on me and when I called back I was met by an answering machine. I still have not received any feedback for a procedure that is at 7h30 tomorrow. 

It is rather disappointing to receive such appalling service and very disgusting for a lack of a better word. 

Not only was I the only one doing the following up my husband too was met with poor service and was also sent from pillar to post. At 17h11 he received an email stating that the medical assessors didn't not receive the picture which was sent by me to [protected]@bonitas.co.za and a gentleman that also assisted me by the name of [protected]@medscheme.co.za also request that I send it to him which he forwarded to [protected]@medscheme.co.za but conveniently the email was not received. Maybe this was done intentionally to inconvenience me so that by the time I need to do the procedure they can safely say that they did not approve the procedure. Is this how you deal with your loyal clients? You show total disregard and no sense of urgency. This is by far the worst treatment and service a client should receive. You took me and my husband for a ride. 

I have been with bonitas for the last 2 years, option BonCap. My company pays for my Medical Aid in full. Last month I needed my son added on my policy, I got the necessary documents from my company's Bonitas represented filled it in and attached all relevant documentation (my son's birth certificate). I was told every thing was in order and that I had a 3 month waiting period.
When the first debit upon adding my son on did not come out of my account I immediately approached the a Bonitas represented assigned to my company as I need my son covered ASAP, and he advised that the documents he had given me were the wrong documents as it did not have the year which is 2018 on the top right hand corner of the documents as it's a new year, he advised me that the Membership Department rejected the documents, I advised him that the Membership Department should have notified me ASAP so we could get the correct documents filled out and not have waited until I noticed that no debit has come off to query this.

I think this is unprofessional as I believe this could have been pushed through or sorted out before the end of February 2018, secondly I should have been notified ASAP from the Membership Department or Bonitas via email or phone that I need the correct documents filled out and submitted and I would have done so ASAP. This is unexcitable and I request this matter be addressed and sorted out urgently.

I now request that my son be added on to my medical aid backdate as from February 2018 as this was the fault of Bonitas or the Membership Department failure to do so will result in my going to the Council of Medical Schemes [protected]@medicalschemes.com. [protected] and Hello Peter.