MJ
Melissa J

1 reviews | Active since Dec 2025

18 Dec 2025, 16:39

Bonitas is penalising me for going to a doctor not on their network even though she is on their list of service providers

I have been with Bonitas since August. This is the first time I've had a claim and I would 1000% not recommend Bonitas as a medical aid provider.

I am on a hospital plan. My daughter needed to get her tonsils removed. I called Bonitas to ask for a list of ENT providers on their network. Once I had the list I called a doctor on there and made an appointment. I made the appointment in October and our appointment was early December. The day of the appointment the doctors secretary was off sick. The doctor decided that my daughter needed the surgery and said I should call later in the week to confirm a date for surgery since her secretary was off sick. When I called the doctor a few days later, the secretary told me that the doctor was actually not a service provider on the Bonitas network. I called Bonitas again to confirm this and the agent I spoke to said it was weird because the doctor is on the list of providers. I then confirm that even though she is not on their SPL they will pay 100% of medical aid rates for the surgery and I would be liable for the shortfall. I understood all of this.

Today I get an email to say that the doctors claim has been processed. When looking at my app I saw that the doctor was not paid scheme rate for one of the procedures. I called to query why this happened. Only to be told that they did not pay scheme rate for that procedure because I was being penalised for going to a doctor outside of the network. They can see that I was given a SPL with that doctors name on it, but essentially they are putting the blame on me because I chose to go with a doctor not on their network, even though she was on the list provided. Not once was I told that I would be penalised for going with that doctor. What a fun surprise just in time for Christmas!

Today I found out that this doctor asked to be removed from the Bonitas network in March. I called for the SPL in October. So for 7 months who did not do their job??

Do not use Bonitas! They will hide information from you just to get more money out of you. **** seriously!

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply19 Dec 2025, 08:16
Official
Hello Mellisa J
 
Thank you for bringing this to our attention. We’re sorry to hear about your experience and appreciate you reaching out. 
 
To assist you further, kindly provide your membership number or the ID number of the principal member privately. This will help us investigate your enquiry while ensuring your personal information remains protected and is not visible on this public forum. 
 
Kind regards, 
 
Bonitas Team