Bonitas Medical Aid - A total "*******" Do not join them unless you want non stop problems. Part 2

Yesterday I wrote a review of Bonitas Medical Aid. They responded but only to ask my name and medical aid number not to resolve the matter.Today when asked about why they allow a R23,500 for MRI and CT Scans (page 33 of pamphlet) per family per year and they could not allow my R3700 from this limit they responded that under their scheme rules a CT colonoscopy is not permitted.

Unfortunately I have another problem with Bonitas with regard to " out of hospital costs"

My wife and I, both pensioners, are on the Bonitas Standard Option which is by far the Bonitas most popular option

On this option the “Out of hospital Benefits” for main member plus one dependant are for GP visits for 2 dependants are R6100 per year. At a “network provider GP “cost of approx R360 per visit this equates to all most 17 visits to a GP per year. I ask how many couples are likely to visit their GP seventeen 17 times in one year, I must remind members that the is no “saving “ on this scheme which means that if you don’t spend it you lose it and Bonitas makes a big profit to sponsor unnecessary things like the Comrades Marathon. The other “out of hospital benefit “ is ( again 1 member and dependant) is R7970 but this is to cover visits to specialists, acute medication, x rays, blood tests and other out of hospital expenses .

My first question is surely Specialists are GP’s (doctors) that have studied further their costs should be taken from GP fees and not from “other” out of hospital benefits. This is borne out by the fact that Bonitas pay Specialists the same rate as GP’s i.e. R360 per visit. The shortfall comes from the members “other” (not GP visits) The second point is that up to a few years ago Bonitas allowed a total amount for “ Out of Hospital Benefits” and this could be used by members to their best advantage without Bonitas then allocating this to their best advantage. One must ask why this was changed and there can only be one answer. Bonitas realised that if they split the “Out of hospital benefit “into GP visits and other, few members would use the full GP allowed amount and Bonitas would score (remember no savings, members loose). But many members run out of the “other” out of hospital benefits and so the members would lose and Bonitas would make more profit. Why does Bonitas not allow a “basket “ containing all out of hospital limitations which would allow members to use this amount to their best advantage. This should not cost Bonitas anymore but actually it would because they would not be able to “*******” their members and make no profits from this. Also note that Bonitas increase their subscription membership fee each year by far more than the inflation rate. In addition previously to see a specialist one just had to be referred by your GP then last year Bonitas required a reference number from your GP practice referring to a Specialist. Now this year your GP has to phone Bonitas and get an approval number for a member can visit a Specialist.

Another problem is that every time Bonitas change their rules they expect members to go on their computers to their web page and find the changes. What about the older members who are not so computer illiterate to find the changes on the computers. We just get left out. It would be really nice if Bonitas could hold a meeting with their pensioner members and in person advise them of the changes . But know this is just far too much trouble, for Bonitas as pensioners are just an added cost to them as well as a problem. These days so many businesses offer discounts to pensioners, but not Bonitas although health the surely the most important issue. I must remind members that to belong to this option costs members with 2 dependants R 5598 per month of R67176 per year and so it is not cheap especially for one who is on pension and whose pension does not go up with the rate of inflation.

As I said in my previous post Bonitas the Medical Aid - do not join them unless you want no stop problems