JP
Juandre P
1 reviews | Active since May 2025
08 May 2025, 18:05
Bonitas Medical Aid Does NOT cover Polycythemia Vera Despite ALL relevant Paperwork Submitted
Dr Jackie Thomson with Practice Number *** has diagnosed me with Polycythemia Vera ICD 10 CODE D45. I have submitted to Bonitas PMB, Claims and Chronic Meds and Tendahealth (Broker) the Letter of motivation from my doctor with all the necessary details, blood tests and quotation since November 2024 up to date (08 May 2025)I have not been successful after multiple attempts. I am now at a stage where I urgently need medical treatment as I can feel the affects that Polycythemia Vera have on my body which is making my daily life extremely difficult. Each day is getting more difficult and I am afraid that I will only get the necessary treatment when it is to late as the Polycythemia Vera can lead to Cardiovascular Disease, Stroke, Blood Clots etc. Which I am trying my best to avoid. I unfortunately do not have the funds to pay cash for treatment. I have pleaded with Bonitas and they just straight up told me the Bonitas DOES not cover Polycythemia Vera at all and it MUST be paid out of my savings (Depleted) otherwise cash more than that they cannot assit me which is EXTREMELY devastating as I am suffering and paying over R3000 a month (For more than 2 Years) for a medical aid that cannot provide cover for the treatment that I desperately need!
Helpful (0)
Replies (7)0
Replies (7)
Bonitas Medical Fund's replyOfficial
09 May 2025, 08:32Hello Juandre P
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 Team
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 Team
Bonitas Medical Fund's reply09 May 2025, 08:32
Official
Hello Juandre P
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 Team
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 Team
JP
Juandre P's updateReviewer Update
09 May 2025, 15:25BONITAS MEDICAL AID AS APPROVED A VENESECTION FOR MY CHRONIC CONDITION FOR ONE DAY ONLY, NO BLOOD TESTS APPROVED WHICH IS REQUIRED TO BE ABLE TO DO THE VENESECTION HOW ELSE WOULD THEY KNOW HOW MUCH BLOOD TO WITHDRAW OR WHAT MEDICATIONS TO PROVIDE? THIS MUST BE DONE UNDER PMB AS IT IS A CHRONIC CONDITION NOT A ONCE OFF TREATMENT IT IS ONGOING. I AM DEVESTATED!
JP
Juandre P's update09 May 2025, 15:25
Reviewer Update
BONITAS MEDICAL AID AS APPROVED A VENESECTION FOR MY CHRONIC CONDITION FOR ONE DAY ONLY, NO BLOOD TESTS APPROVED WHICH IS REQUIRED TO BE ABLE TO DO THE VENESECTION HOW ELSE WOULD THEY KNOW HOW MUCH BLOOD TO WITHDRAW OR WHAT MEDICATIONS TO PROVIDE? THIS MUST BE DONE UNDER PMB AS IT IS A CHRONIC CONDITION NOT A ONCE OFF TREATMENT IT IS ONGOING. I AM DEVESTATED!
JP
Juandre P's updateReviewer Update
09 May 2025, 15:51Hi There,
I would like to raise a serious concern regarding the recent response I received from Bonitas Medical Aid, dated 09 May 2025, in which they granted authorisation for only one day of treatment for a medically diagnosed, life-threatening chronic condition, Polycythemia Vera.
While I appreciate the acknowledgment of the ICD-10 code (D45) and the approval of a single venesection (the****utic phlebotomy) on 15 May 2025, this is grossly insufficient and inappropriate for the management of this Prescribed Minimum Benefit (PMB) condition. The treatment of Polycythemia Vera is not a one-time procedure—it requires ongoing, medically supervised venesections, often on a monthly basis, to maintain hematocrit at safe levels and prevent stroke, blood clots, and other serious complications.
The approval of only one day's treatment is not in line with PMB regulations or standard medical protocols for the management of hematologic malignancies. This limited authorization puts my health at serious risk.
I therefore request that:
1. Bonitas be compelled to authorize ongoing venesections under PMB, not as isolated, once-off procedures.
2. A formal investigation be conducted into their systemic denial or restriction of PMB access for chronic conditions.
3. The CMS issue guidance or an order to Bonitas to treat Polycythemia Vera as the chronic, PMB-qualifying condition that it is.
I am attaching the authorisation letter received from Bonitas as proof of this insufficient response.
Thank you for your time and urgent assistance.
Sincerely,
Juandre Pretorius
Cell: ***553
Email: ***
JP
Juandre P's update09 May 2025, 15:51
Reviewer Update
Hi There,
I would like to raise a serious concern regarding the recent response I received from Bonitas Medical Aid, dated 09 May 2025, in which they granted authorisation for only one day of treatment for a medically diagnosed, life-threatening chronic condition, Polycythemia Vera.
While I appreciate the acknowledgment of the ICD-10 code (D45) and the approval of a single venesection (the****utic phlebotomy) on 15 May 2025, this is grossly insufficient and inappropriate for the management of this Prescribed Minimum Benefit (PMB) condition. The treatment of Polycythemia Vera is not a one-time procedure—it requires ongoing, medically supervised venesections, often on a monthly basis, to maintain hematocrit at safe levels and prevent stroke, blood clots, and other serious complications.
The approval of only one day's treatment is not in line with PMB regulations or standard medical protocols for the management of hematologic malignancies. This limited authorization puts my health at serious risk.
I therefore request that:
1. Bonitas be compelled to authorize ongoing venesections under PMB, not as isolated, once-off procedures.
2. A formal investigation be conducted into their systemic denial or restriction of PMB access for chronic conditions.
3. The CMS issue guidance or an order to Bonitas to treat Polycythemia Vera as the chronic, PMB-qualifying condition that it is.
I am attaching the authorisation letter received from Bonitas as proof of this insufficient response.
Thank you for your time and urgent assistance.
Sincerely,
Juandre Pretorius
Cell: ***553
Email: ***
Bonitas Medical Fund's replyOfficial
13 May 2025, 09:07Hello Juandre P
Thank you for submitting a comment to us through hellopeter.
According to the telephonic conversation with our clinical department, we hereby confirm that your concern has been addressed, and this matter has been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concern to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Regards
Bonitas Team
Thank you for submitting a comment to us through hellopeter.
According to the telephonic conversation with our clinical department, we hereby confirm that your concern has been addressed, and this matter has been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concern to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Regards
Bonitas Team
Bonitas Medical Fund's reply13 May 2025, 09:07
Official
Hello Juandre P
Thank you for submitting a comment to us through hellopeter.
According to the telephonic conversation with our clinical department, we hereby confirm that your concern has been addressed, and this matter has been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concern to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Regards
Bonitas Team
Thank you for submitting a comment to us through hellopeter.
According to the telephonic conversation with our clinical department, we hereby confirm that your concern has been addressed, and this matter has been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concern to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Regards
Bonitas Team
JP
Juandre P's updateReviewer Update
13 May 2025, 13:57Where has it been resolved??
I am still not covered, this query is NOT resolved. I have received ZERO feedback from anyone!
Will I get feedback when I am already dead? I am sitting here suffering due to Bonitas delays in having this query resolved!!
I have handed this case over to CMS due to the lack of service, communication and care from Bonitas.
I am still not covered, this query is NOT resolved. I have received ZERO feedback from anyone!
Will I get feedback when I am already dead? I am sitting here suffering due to Bonitas delays in having this query resolved!!
I have handed this case over to CMS due to the lack of service, communication and care from Bonitas.
JP
Juandre P's update13 May 2025, 13:57
Reviewer Update
Where has it been resolved??
I am still not covered, this query is NOT resolved. I have received ZERO feedback from anyone!
Will I get feedback when I am already dead? I am sitting here suffering due to Bonitas delays in having this query resolved!!
I have handed this case over to CMS due to the lack of service, communication and care from Bonitas.
I am still not covered, this query is NOT resolved. I have received ZERO feedback from anyone!
Will I get feedback when I am already dead? I am sitting here suffering due to Bonitas delays in having this query resolved!!
I have handed this case over to CMS due to the lack of service, communication and care from Bonitas.
JP
Juandre P's updateReviewer Update
14 May 2025, 11:04PLEASE PROVIDE FEEDBACK??????
JP
Juandre P's update14 May 2025, 11:04
Reviewer Update
PLEASE PROVIDE FEEDBACK??????
JP
Juandre P's updateReviewer Update
14 May 2025, 16:47After Sending emails for a follow up as they stat this query is now "resolved" Suzette from Medsheme is now non responsive! This is absolutely Ridiculous! I am now left paying medical aid and get no service or cover for a chronic condition!
JP
Juandre P's update14 May 2025, 16:47
Reviewer Update
After Sending emails for a follow up as they stat this query is now "resolved" Suzette from Medsheme is now non responsive! This is absolutely Ridiculous! I am now left paying medical aid and get no service or cover for a chronic condition!