Careful when choosing a medical aid

Joined Bonitas Medical Fund in December 2022-first premium deducted in January 2023. In April 2024 I went to see Dr. David J Engelbrecht with a swollen knee. On investigation by the doctor it was discovered that I required knee replacement surgery.

Bonitas refused to pay for the surgery citing that the Hospital plan that I was on did not cover knee replacement surgery. (BONESSENTIAL SELECT).,this despite motivation letters from the surgeon and my rheumatologist.

I was told that if I wanted the procedure done, I will have to change my plan to full medical aid at a cost of R4,600. I then enquired about the P.M.B. option as Rheumatoid Arthritis is covered as per 24 in their brochure and the knee problem was caused by the arthritis.

Despite all of this and emails back and forth the fund managers were adamant and did not come to my rescue .(so much for the advert that says we are there when you need us).

I terminated my membership in May,2024-and joined Momentum Medical Hospital Plan (Custom Option) in June 2024. I am pleased to say that Momentum have just authorised the knee replacement surgery .

I must state that the premiums for Bonitas and Momentum were very similar, and yet Momentum came through for me.

TIMOTHY N.DAVID