Bonitas Medical Fund
Reviews and Complaints

Good day
I am very disappointed in the way claims is handled by Bonitas, my husband got burned in April 2021 and Bonitas is not paying the hospital or the skin clinic or the pathologist. I am sitting with all these accounts that was not paid and Bonitas is not even coming back to let me know if they are still busy with the accounts or reason why they are not paying. This was an emergency situation where i needed help and did not get it - this is the reason a person have medical aid. I don't even get a call to let me know there is a problem like outstanding documents or no cover. I have been sending mails but i only get auto response with a query number on
Your query number is : 220921QSXYZM.
I would like if Bonita`s can respond to the mails i have send and solve the query or please call met on [protected]
I am on the Boncap option

I was admitted into hospital on the 4/05 and underwent surgery on the 07/05/21. My dr has used incorrect code which was later ammended, the secretary from the dr rooms and was assisted by a consultant. Mvulani vilakzi replied saying that code 2506/2467/1809 are all going to be paid but later there is rejection saying that 2506/2467 are rejected. This is totally unacceptable. I need this to be corrected immediately as this has been going on from may till current.

My contact number is [protected]

Hi , [protected]
Please urgently refer me to the CEO to make a call please . Im totally frustrated, stressed and getting even more ill day by day as my bills are just piling up. This is a pandemic and all my bills are taken out from savings . I was tested positive for covid on the 17 July 2021 and I am still struggling to recover . I have long covid syndrome. Marilyn Herron has been assisting me and she has been very helpful however im running out of time  and becoming even more sick day by day as she is in training and her responses are now negative and she is no longer able to assist me
1. I need all Dr Hansraj consultations to please be placed under pmb or annual . It seems the ICD 10 is incorrect.  Maybe the doctor is submitting incorrectly. She is my consulting doctor and assisting Me with my recovery however my benefit is now exhausted . I have more appointments coming and my consultations are now exhausted as my doctor Is using the wrong Icd code. I will end up dying should I not get the needed help. I need by gp benefits back and I need to advise the doctor to use to correct icd 10 as its long term covid so that pmb and overall limit can be used

2. Attached is the physiotherapy letter.  Can the physio consultation be placed under pmb or annual limit . Must a certain  icd 10 code be used . Please advise . I have made no appointment yet as the doctors are using the incorrect icd. I need direction..i need approval and advice on what icd 10 code to be used to be placed on pmb or overall. It's for covid after all.

3. I need to make an appointment with the physician . Can the physician consultation be placed under pmb or annual limit . Must a certain  icd 10 code be used . Please advise. As im fighting a losing battle as the doctors are using incorrect icd codes and exhausting the medical aid.i need approval and advice on what icd 10 code to be used to be placed on overall or pmb as the doctors are submitting incorrectly

4. I have purchased appliances as I had covid pneumonia as per the report from the doctor at sunninghill which was submitted to bonitas . I would not be able to get a referral now as it's a bit late now however discovery gives their covid positive patients oximeters for free. Why should I have have to apply for the necessary appliances needed in my sick state. I lost the slip for the steamer and the humidifier due to my condition so I will forget that.i did sent through the slip for humidifier, thermometer and the oximeter but that needs doctor approval for a sick covid patient. Come on guys. I had to use take a lot as I was bed ridden and clicks and dischem had no available cheaply priced items or all out of stock.

5. I sent in slips for medication purchased at dischem. The levy items can be left out and the other meds looked into under pmb . This is a pandemic totalling R 821.41
5. I also made an upfront payment for R 1200 at midstream hospital as I was terribly ill.

Can you please review as my recovery is depending on all this treatment  I need to get . Please help me . Im fighting for my life but all my gp savings is depleted and I can not recover without the needed help . I'm trying hold onto to the last R3000 day to day I have should anything further come up . I need my gp savings to be reinstated and covid to be placed under pmb and overall. I still have a long way to recovery

Please help me 

Edlin
Edlin.[protected]@gmail.com

[protected]

Membership [protected], surgery done on 03/08/2021. Medical aid approved the operation yet we had to pay R4400 before the operation could proceed. We submitted a claim on 18/08/2021 with no response. On 19/08/2021 a Bill of R3108. 44 was issued by die doctor for payment by us. Yet the operation was approved by bonitas. Why would we Pay for this if Gap cover is Part of the Membership.

I don't know where u guys get the nerve to deduct money from my payroll for the last six months... I am completely disgusted and want to be paid back. I am not even a member of this stupid scheme. My ID number is [protected]. I urge the public to run when they hear anything bonitas, highly inefficient and not very attentive staff member... Total crooks.

Good day. Please help me as I am desperate to get my membership certificate form Sizwe. I have phone twice and was told that they have sent a mail to the relevant department to ask for a member ship certificate burt to no avail.  I am ending my current membership on Wednesday 31st March at Netcare and my new medical want to give me a waiting period plus a penalty for late joiners because I am not producing the membership certificate.I was a member at Sizwe from 1.12.1999 until 30.9.2001 and my membership no was [protected].Please help as Im retiring and cannot afford the extra penalties as I will be on a tight budget.It will be most appreciated.RegardsRosemary HerselmanID [protected]

I am Sesi Roseline Maile member no 47001202815 on Boncap option. I have three beneficiaries which are, my spouse and my two kids (boys). I have a problem on my medical aid not paying my bills/accounts after consultation since last year either at hospitals or doctors surgery. I have thousands of rands that I OWE to mediclinic in Vereeniging and doctors around Vaal where my family are consulting. I cannot afford to pay all outstanding fees from them as I took each member of the family to health care knowing that I have medical aid which I was paying even during the lockdown period.

What frustrates me the most is that, I only get notification that I owe the doctor or the hospital after days of consultation. Ain't the medical approve before the service that they wont pay and state the reason why because both hospitals and doctors enquire from them before? They (Bonitas) don't even send me the message or inform me either way that they didn't pay my claim due to reason/s known by them. I think Bonitas is scamming us and taking both my and companies monies every month without any assistance. Really I am tired and frustrated of Bonitas, I don't know how many claims from the doctors and hospital for Relebogile Maile which is member no 3, Myself and Molebogeng Maile member no 2 were rejected please I need an explanation and I cannot afford to pay so many claims while I'm paying Bonitas every month.

My son is a transplant patient with bonita medical aid his medication was supposed to be dispatched two weeks ago, there was a shortfall, however we made payments, and on the friday a guy by the name brian phoned my son to say that he will receive the med's same day in the afternoon, this was on the 19th feb, we waited the weekend and still no delivery, this was medication to slow down the process of injuring his new kidneys, my son has been admitted to hospital from the 20th feb, today is the 22nd feb and he still waiting for his med's, now it's around 4 o'clock I phoned in they say that it will be delivered tomorrow, this is my sons health that this company is playing around this actually caused him to be admitted in hospital, I want to take this up further with pharmacy direct and want compensation for my sons health issues

Good day,

I'm a very unhappy customer not impressed with service at all.
I needed to re schedule my procedure as I did not received any authorization number. I keep on phoning in and sending emails as I do not get any feedback.
When I follow up on my ref Bon23712174 the lady told me the specialist referral number from my GP is wrong and as per GP its correct - No agent phoned or send email to inform me up until I phoned in.
I'm paying this medical aid for a year now and never used it. Now the first incident am getting this bad service. This is ridiculous and if its not getting sorted today then I will rather make a decision to move to another medical aid because this is unacceptable to wait this long for authorization number and no feedback from the scheme. Kindly email feedback to [protected]@gmail.com

Good day,

Following the POPI-act my information is not permitted to be given to any third party without my written authorization. This was done! Can you please phone me?

Goodmorning

I am Neliswa Matayile a member of Bonita scheme, my membership number is [protected], primary option and my ID is [protected].My husband Mandithini Matayile, code -01 is registered on Chronic medication and pharmacy director is a supplier. Apparently we have been so concerned that the pharmacy does not supply the v ectoryl plus as one of the medication on the doctors script. This has happened so long without noticing. My husband was in and out of hospital. They decided to kept victoryl plus as their co payment. They just decided, not asking nor how is important is the medication in my health. When I tried to understand they ignored me.
They just send this note:

PHARMACY DIRECT BANKING DETAILS : Nedbank, Account nr [protected], Branch code 198765. Please use your profile nr 3BE4D7 as reference.R145.49 ON YOUR ACCOUNT - THAT IS WHY VECTORYL PLUS CANT BE SEND OUT. THANK YOU
This note to me does not explain anything
Covit-19 is killing people and my husband is in risk.

The second one, I have been struggling with different accounts, not being paid and that put me on a tight corner, finding myself to pay more money on different accounts. I am sure, you notice there is a lot of money deducted from me for this medical aid. I would like to know therefore that there is no way that you can help me.

You can furnish me with you email as to send all account.

Mr. MANDITHINI MATAYILE

Good day,

Attached please find your debtor statement for the above mentioned hospital. Notwithstanding previous requests for urgent payment, it remains in arrears. Contact us within 7 days from this email date to avoid legal action being taken against you.

Failure to respond to us will result in listing at the National Credit Bureau.

Regards

Sophia Fourie

Credit Controller | Debt Collections

MEDICLINIC SOUTHERN AFRICA

Chardonnay Building

Brandwacht Office Park

Trumali Road

Stellenbosch

7600

PO Box 456

Stellenbosch 7599

T +[protected]

F +[protected]

Please assist:
Email: [protected]@gmail.com

-24 April 2020

-[protected]

- Bonitas paid monies (R 5010.00) into my bank account instead of paying it to the Specialist that treated me.
Bonitas then contacted me about their error and requested I make arrangements to pay them the money back.
Bonitas provided me with their acknowledgement of debt form which I had to sign and return to them (which I did).
I agreed to make 2 payments of R 2505.00 starting from December 2019 and January 2020.
On April 22 nd 2020 my wife had to seek urgent Dental treatment and attended the Dentist which is where my wife was informed that our Medical aid was suspended.
This was the first time that I came to know that my medical aid was suspended.
On calling the Bonitas customer care, I was informed the suspension was due to me not paying my outstanding debt (R 5010.00).

My argument is that Bonitas made me complete the acknowledge of debt form and I handed it back to Bonitas as requested for them to implement.
Your Finance department specifically said to me that Bonitas will effect the debit order (listen to the records of the conversation I had with your Finance department) and I had no idea the monies were not deducted.

When I heard of the reason for the suspension I immediately on the 24 April 2020 paid the outstanding debt despite facing some serious financial challenges due to the lockdown.
I wrote to Bonitas of my unhappiness of they way they handled my matter especially at the height of the Covid 19 Lockdown and the strain and stressors we were experiencing for Bonitas to suspend my medical aid without informing me of the outstanding monies which I was not aware of.
Furthermore I was informed that my employers were continually paying my Bonitas subscriptions which indicated I was not defaulting in my payments.

I've written several emails to Bonitas since 24 April 2020 requesting they confirm my payment of R 5010.00 and for official confirmation of my medical aid being re-instated.
I've also asked for my wifes Dental treatment cost of R 800.00 be paid given my medical aid was re-instated.
To date I have not received a reply from anyone in Bonitas.
I had to call the customer care yesterday who kept me waiting on the phone before she could answer me and finally I could not wait anymore because of my telephone bill increasing.

I believe Bonitas conduct to suspend my medical aid was inhumane and gross violation of my human right especially at a time when the entire world is going through a terrible pandemic that is causing severe strain to our health and well being and I needed my medical aid.
It was not my fault that Bonitas did not do their job by effecting the debit order as they had my bank details and the acknowledgement of debt form.

My family and I are desperate to have our medical aid reinstated and if so require official confirmation.
I also require the dental treatment bill of R 800.00 to be settled urgently

The Finance department official that initially handled my matter was negligent in not processing my debit order and should face disciplinary action

Im still struggling with my debit orders. Ive changed my banking details to capitec. My income is paid on the last day of the month and is from another bank. So it take 24 to 48 hours to reflect on my capitec account. Which will only reflect on the 2nd of each month. So I had to fill in a form and sent it back on the 24th of march 2020. They couldn't assist me to change the date of my debit order to the second of each month! They said they would come back to me but its 35 days later and nothing. Ive been emailing and emailing! I got like 5 different query numbers but nothing. Its almost end of month and that debit order is going to bounce back and im going to sit with the banking costs not bonitas. I should change to another medical aid after lockdown

Hi

Eversince i have tried to get my son on BOncap bonitas has been giving me the run around and very little communication.
18/02/2020 i phoned to enquire abaout the status of my son's application i was told its with a Broker. (180220QWW4YH).
On the 03/03/2020 same thing (030320QXWVPF), i was told it should be finilized by the 13/03/2020.. Nothing
i followd up again on the 17/03/2020 was told still with the Broken has not yet been finilised. (170320QYLGPH)
i phoned today and was told its still not been finilised.

We've had the absolute worst service since joining Bonitas.

Bonitas deducted the wrong amount for the first month, as per their advice this was corrected in the second month via EFT. Account still shows as suspended due to shortfall.

Another horrible experience, my mother clearly had NO waiting period as per the document received and after speaking to consultants at Bonitas. We could still not get her admitted due to a waiting period which apparently according to you she did not have, however the hospital's system clearly showed that she was on a waiting period.

Why are you even selling medical aid if you do not want to provide a service!

have been handed over to attorneys and I'm going to be blacklisted due to a shortfall amount that my medical aid (Bonitas) didn't pay. This claim is for 2016 and till this date it hasn't been resolved. I have been in touch with the medical aid and the hospital the case manager at Bonitas, but that didn't resolve this problem. I'm now told that the problem is with the hospital and not Bonitas. After so many years, I'm only hearing this information today (12March2020) for a case that is from 2016. I feel that my medical aid has failed me as now I have to pay an amount of R10000 form my own pocket as they are saying its not their fault.

See below

Dear Peter Thobakgale,

Thank you for your email dated 12 December 2018 on query number 121218Q51XSX.

Kindly be advised that we have forwarded your claim query for Wilgers Hospitaal for the service dated 03/08/2016 to the Hospital Claims Department for further assistance, feedback will be provided soon.

Should you require any further information, please contact customer services on **********or email us at ***********

Please update your personal details on a regular basis to ensure that you receive the latest updates from Bonitas.

Best Wishes,

Dorah Maboe

I had a in room procedure booked for 27 February and got authorisation, but only got authorisation for some of the codes on the quote. I moved my procedure to 12 March 2020 but had to move it AGAIN because I'm not getting ANY feedback. There are alot of codes on the quote and I need clarity what Bonitas will pay and what they will not pay. I need to know BEFORE I go for the procedure what is covered and what not, at the end of the day I have to know if I can afford to go for the procedure. This procedure is now moved to 7 May 2020. The fact that I get NO FEEDBACK from Bonitas is really unacceptable!
A van Zyl - Member nr: [protected]
Patient Name: Mrs Anika Van Zyl
DOB: 26/06/1979
Medical Aid: Bonitas
Plan Type: Bonsave
Member #: [protected]
Contact #: [protected]

Procedure Date: Thursday, 7 May 2020 @ 12pm - IN ROOMS PROCEDURE
Procedure Name: Unilateral Radiofrequency Ablation (RFA), Unilateral Phlebectomies & Unilateral Ultrasound Guided Vein Embolisation
ICD10 Code: i87.2
Procedure Codes: 1413 / 1417 / 5022
Modifier Codes: 0004 / 0009 / 0007 / 2802 / 5114 / 5115 / 0202 / 0206
Special NAPPI Codes: [protected] (Closurefast 7F Cathether) / [protected] (Sheath Introducer) / [protected] (VNUS Tubing Tumescent Pump)

I NEED URGENT FEEDBACK IN WRITING!

Why isn't Bonitas coming up with a solution on how the claims department can communicate or give feedback to clients when there's a delay in refunds or claims are rejected due to outstanding documents. There only time I get to find out if there's delays or issues, is when I realise the claim is not paid after the turn around time has lapsed because no one bothers to make contact and this is not the first time. We join medical aid for a reason so that we don't have to pay cash for medical consultation but unfortunately some specialist require cash then we claim from medical aid. It is not our intention to pay cash as we don't have the money to. Sometimes when I claim, the refund is paid within the 10 days turn around time,. However when there's delays, no bothers to come back and tell me there's queries or a system issue for the claim I submitted. Like today, I submitted a claim on the 24th of January 2020 but did not receive any feedback what so ever regarding the claim. I had to call in only to be told there's a system issue regarding this particular claimed submit but why wasn't I informed. This is poor service delivery from your end. I'm not sure why this is not corrected as it causes frustration for me as a client.