Bonitas Medical Aid -Co payments

Bonitas advirtise that they are here when you need us. It really should say we will not be here when you need us.

I am 80 years old and still have to work as I cannot afford to retire. Just my medical aid payment to Bonitas for me and my wife is R 19,000 per month. I developed life treatening heart disease and needed a TAVI procedure as I would not hsvr survived open heart surgery which Bonitas authorised in November 2023 to the Dr M Geka's practise at Netcare Sunninghill hospital with a co payment from me of R 26 500. Nothing was said that they would not pay for the prosthesis if R261,536. During the procedure which was carried out on 17.11.2023 a piece of cholestral broke off and entered my brain resulting is a stroke and permanent loss of vision. After some rehab at Midstream hospital which Bonitas paid I received an invoice from Netcare Sunninghill for R 191 749 as Bonitas only paid R 43,286.04 out of the mandated amount R 261,536 for a replacement valve I approached Bonitas who advised that my benefites were exceeded for the Prosthesis and they just rep**** that it was up to me to pay the difference. Prior to the procdure I was only advised that my copayment would be R26 500 and nothing was mantioned that Bonitas would not pay for the valve or that my benefits were exceeded. I could have waited a few months for gap cover I had previously taken out be in force. I could not obtain any help from Netcare Sunninghill as they only wanted their money. Dr Gebka's lady (to whom I am grateful) spoke to Bonitas and she gets 5 stars on my behalf and Bonitas agrred with her that they had made a mistake and woul reprcess the oustanding amount if R 218,249. Instead of Paying R 191,749 Bonitas only paid R 158,132. Netcare Sunninghill have ignored that Bonitas R 43,286.04 to wards the valve and still me to pay another R 33, 616.95. There should not be anything owing. Bonitas is managed by Medscheme who operate with a call centre and there is no continunity with the persons dealing with a query. Despite sending Bonitas / Medscheme corresponce from Dr Gebkas lady who deals with Authorisations and Netcare Sunning Hill all I have received is that my benefits are were exceeded which Med Scheme already admitted was an error. The treatment from Bonitas, Medscheme and Netcare Sunninghill is apalling and peopele need to make sure that when advised of a copyment that it will not be increased after whatever procedure has been agreed to