Bonitas Medical Aid - A total "*******" Do not join them unless you want non stop problems.

I am a pensioner and unfortunately have no choice what medical aid I am on and unfortunately am on Bonitas Standard Option. I have non stop problems with Bonitas and the following is the latest example.

I suffer from chronic and sometimes acute diverticulitis , this follows the removal of part of my colon some 20 years ago when I had 5 operations over a 3 year period. As I have got older my diverticulitis has worsened. I was hospitalized about a year ago and spent several days in hospital. Recently the pain became unbearable and my GP, after giving me very strong antibiotics that did not work, recommended me to a very well known Gastroentromologist. After a full examination at a cost to me of R1500 ( my "other" out of hospital costs already exhausted) I was sent for a CT colonoscopy at Dr. Kaufman and Partners. The surgeon completed the required forms which I e mailed to Bonitas. After over a week of severe pain I phoned Bonitas who then advise that I must go to Kaufmann and they would do the Bonitas Approval. After making the booking and taking the required medication (Pecoprep plus more), I was informed by Dr Kaufman that Bonitas had refused my authorization. This was less than 12 hours prior to my pre booked CT Colonoscopy. Because of the severe pain I decided to pay for the CT colonoscopy myself ( over R3700) and went ahead. The colonoscopy was sent to the Gastroentromologist who advised me to contact my surgeon. The severe pain continued and I was admitted to hospital on the 15 April via Emergency. My surgeon was called and after full examination he advised , after looking at the CT scan that I should have part of the sigmoid colon removed but because of the complications of the previous operations and my age the operation would be risky. I then decided, after being in hospital on a drip for several days, to try the non surgical route at this stage and follow a strict gluten free diet. I am due to visit the surgeon again in early May.

On getting home I obtained the motivation required by Bonitas for the CT colonoscopy and sent it to them.

I have today been informed that despite this motivation and the fact that I offered to see any specialist/ surgeon that Bonitas might recommend ( at their cost) has been declined. Bonitas has put a "care plan" in place for me.

What I cant understand is how after a referral from one of the top Gatroenromologists in KZN ,or the country, Bonitas has the right not to accept the recommendation. This does just not make sense. How can a legitimate medical aid refuse a request made by a specialist surgeon. They are in fact saying that they know better than the specialist/surgeon.

Maybe Bonitas would rather their older members just pass on rather than cover their costs