TG
Thabile G

1 reviews | Active since Dec 2015

21 May 2025, 18:51

Claims deducted from medical savings instead of Hospital Benefits whilst admitted in hospital

I'm shocked to find my medical savings depleted despite being hospitalized from February to March 14. Bonitas Medical Aid charged my savings for admission days, citing that service providers submitted claims as outpatient services. This is unfair, as the medical aid is aware of my admission dates, and other costs for those days were covered by hospital benefits.

I was advised to call service providers and ask them to rectify their submissions. I spent more than 3 hours today with them and the medical aid. The situation is further complicated by the service providers, who have no interest in resubmitting claims since they've already been paid. With 5 members on my plan, including children, it's alarming that my savings are exhausted in May.

I'm still recovering and unable to visit a doctor due to having my savings depleted. I am in debt due to outstanding co-payments of over R8,000 and short payments from the medical aid that I need to settle. I don’t even think the medical aid deserves a start I have in hospital for close to 2 months, haven’t fully recovered now I have to deal with this and this is not fair.

0
Replies (3)
TG
Thabile G's update21 May 2025, 21:20
Reviewer Update
Your brochures state that blood tests are unlimited when one is hospitalised, however I find myself owing Lancet and Ampath for tests that were done whilst I was admitted. I was also treated for Asthma, I did physio which was not paid for under hospital plan and yet asthma is in you list of pmb's.
Bonitas Medical Fund
Bonitas Medical Fund's reply22 May 2025, 08:50
Official
Hello Thabile

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
TG
Thabile G's update22 May 2025, 16:50
Reviewer Update
I’m curious—how do you intend to investigate this matter without even requesting my details? Or is this just a standard response designed to pacify clients rather than truly addressing their concerns?