1 reviews | Active since Jan 2021
Day to day limits
Good day
Could you please provide clarity on the day to day benefits and sub-benefit limit of a family which consists of a main member and 3 dependants.
For a family which consists of a main member and 3 dependants you currently get the following benefits: (Per family of 4) Day to day- R22 000
Day to day sub-limits which is subject to available day to day benefits: (Per family of 4) GP & Specialists consultants = R6 000 Acute & OTC medicine = R6 000 Xrays & Pathology Services = R6 000 Auxi****y Services = R6 000 Total amounts to R24 000, but for only have R22 000 at our disposal.
Bear in mind this is subject to available day to day benefits, which automatically means we start of with a negative balance. This also means we only have R5 500 at our disposal for the each sub benefit.
How does all of the above make sense?? Is it fair to make R24 000 available, yet you can only use R22 000??
The OTC medicine benefit is as follow: R800 per member with a maximum of R2500 per family.
A family of four benefits would look as follow: Member 1: R800 Member 2: R800 Member 3: R800 Member 4: R100 (MAXIMUM OF R2500 PER FAMILY FOR OTC MEDICINE) OR Member 1: R625 Member 2: R625 Member 3: R625 Member 4: R625 (MAXIMUM OF R2500 PER FAMILY FOR OTC MEDICINE
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.
Kindly provide us with your membership number or ID number to assist with your enquiry. We appreciate your patience while we are resolving this query for you.
Kind Regards
Bonitas
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.
Kindly provide us with your membership number or ID number to assist with your enquiry. We appreciate your patience while we are resolving this query for you.
Kind Regards
Bonitas
This is a very generic response to the query raised. Did you actually read through the complaint? Or did you just copy and paste this response.
Currently on the Standard and Standard Select options you pay for up to three child dependants.
This would effectively mean that your day to benefits for a family of 5 would be the same amount (R22 000) per family as to that of a family of 4, despite the fact that you are contributing more as a family of 5.
This also effectively means that as a family of 5, two dependants will not benefit from the OTC medicine benefit as the maximum per family is R2500 with a sublimit of R800 per member (R800×5=R4000)
This is a very generic response to the query raised. Did you actually read through the complaint? Or did you just copy and paste this response.
Currently on the Standard and Standard Select options you pay for up to three child dependants.
This would effectively mean that your day to benefits for a family of 5 would be the same amount (R22 000) per family as to that of a family of 4, despite the fact that you are contributing more as a family of 5.
This also effectively means that as a family of 5, two dependants will not benefit from the OTC medicine benefit as the maximum per family is R2500 with a sublimit of R800 per member (R800×5=R4000)
Do you know how stupid this sounds??
Do you even know what the price of medicine is???
So all of your maximum limits is based on the assumption that not everyone wil use their benefits equally. You are basically forcing us not to utilize the entire R800 per beneciary that has been allocated to us.
Utter disgrace I tell you. Day light *******.
Can you please supply me with th details of the medical aid ombudsman, I will escalate the matter to them.
Do you know how stupid this sounds??
Do you even know what the price of medicine is???
So all of your maximum limits is based on the assumption that not everyone wil use their benefits equally. You are basically forcing us not to utilize the entire R800 per beneciary that has been allocated to us.
Utter disgrace I tell you. Day light *******.
Can you please supply me with th details of the medical aid ombudsman, I will escalate the matter to them.