LS
Lucas S

1 reviews | Active since Apr 2021

15 Jul 2025, 15:06

Bonitas Medical Aid -Declined Spinal surgery to a patient who is in pain everyday.

BONITAS MEDICAL AID- Declined authorisation for Decomperssion and fusion for Spinal Stenosis. The neurosurgeon sent all the documents and scans required with motivation. The authorization was declined saying that spinal surgeries are not covered under the primary option which I only found out today 15/07/2025. I am not happy with the decision made as the patient is my mother, she is in pain, being denied an operation while I've been paying the medical aid. No one has been admitted in hospital since last year. They are even refusing to cover under PMB's. What should I do now?? They say upgrade to standard as if it's going to take 1 day. The patient is due for operation on the 17/07/2025. They are also saying I should pay out of my own pocket if I choose to continue with the procedure. The 59 year old woman is in pain on a daily basis. The pain medication she is on currently is not effective. That is why the Dr. said spinal surgery is the only solution. I am not happy at all. Please be transparent and when reviewing your authorization think about the patient. She is in pain, needs spinal surgery and now it's declined with an option of just saying upgrade to a higher option. I'm so disappointed. My membership will be canceled by end of this year.

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply15 Jul 2025, 16:12
Official
 Hello Lucas S

Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve. 
 
We will investigate this matter. 
  
We appreciate your patience while we are resolving this query for you. 
 
 Kind Regards 

Bonitas