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hansraj.annie hansraj.annie
1 reviews | Active since Aug 2016
19 Aug 2020, 11:50
DEMAND FOR CO PAYMENT BY BONITAS MEDICAL FUND
I have been a self paying member of this fund since 2017 after Liberty Medical Aid amalgamated with Bonitas Medical Fund. I have been a self paying member of Liberty Medical Aid from 2014 and experienced no problems. I have a problem of hyperlipidaemia and have suffered severe side effects with other lipid lowering agents. I provided proof of this to the fund as I am a highly active person and cannot stand the myalgia with other lipid lowering agents. I have shown how my Creatinine Kinase and Myoglobin levels were raised due to other lipid lowering agents. The fund insists on a co payment despite the fact that the Medical Schemes Act explicitly states that the fund must pay in full should the member provide proof that the other agents are detrimental to them. This is highly disappointing because I am a member on one of the higher plans on Bonitas. If they insist, I will change to a fund that listens to my health.
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Replies (4)
Bonitas Medical Fund's replyOfficial
19 Aug 2020, 13:15Hello Hansraj S,
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
We appreciate your patience while we are resolving this query for you.
Regards,
Bonitas Team
We appreciate your patience while we are resolving this query for you.
Regards,
Bonitas Team
Bonitas Medical Fund's reply19 Aug 2020, 13:15
Official
Hello Hansraj S,
Thank you for submitting your details to us through Hello Peter.
This is to confirm that we have received your information and that we are currently investigating this matter.
We appreciate your patience while we are resolving this query for you.
Regards,
Bonitas Team
We appreciate your patience while we are resolving this query for you.
Regards,
Bonitas Team
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hansraj.annie hansraj.annie's updateReviewer Update
19 Aug 2020, 13:51This has been my last resort because nobody at Bonitas or the Council for Medical Schemes seems to understand the Medical Schemes Act and how it serves the public. In fact, the former health minister, Aaron Motsoaledi, stated that there should be no co payments, as enacted in the new Medical policy in preparation for the NHI.
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hansraj.annie hansraj.annie's update19 Aug 2020, 13:51
Reviewer Update
This has been my last resort because nobody at Bonitas or the Council for Medical Schemes seems to understand the Medical Schemes Act and how it serves the public. In fact, the former health minister, Aaron Motsoaledi, stated that there should be no co payments, as enacted in the new Medical policy in preparation for the NHI.
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hansraj.annie hansraj.annie's updateReviewer Update
19 Aug 2020, 15:14I further refer you to the Medical Schemes Act 131 of 1998
15 H. Protocols
If managed health care entails the use of a protocol -
(c) provision must be made for appropriate exceptions where a protocol has been ineffective or causes or would cause harm to a beneficiary, without penalty to that beneficiary.
(Regulation 15H inserted by regulation 14 of Government Notice R1360 in Government Gazette 24007 dated 4 November 2002.)
15I. Formularies
(c) provision must be made for appropriate substitution of drugs where a formulary drug has been ineffective or causes or would cause adverse reaction in a beneficiary, without penalty to that beneficiary.
Thank you
15 H. Protocols
If managed health care entails the use of a protocol -
(c) provision must be made for appropriate exceptions where a protocol has been ineffective or causes or would cause harm to a beneficiary, without penalty to that beneficiary.
(Regulation 15H inserted by regulation 14 of Government Notice R1360 in Government Gazette 24007 dated 4 November 2002.)
15I. Formularies
(c) provision must be made for appropriate substitution of drugs where a formulary drug has been ineffective or causes or would cause adverse reaction in a beneficiary, without penalty to that beneficiary.
Thank you
hh
hansraj.annie hansraj.annie's update19 Aug 2020, 15:14
Reviewer Update
I further refer you to the Medical Schemes Act 131 of 1998
15 H. Protocols
If managed health care entails the use of a protocol -
(c) provision must be made for appropriate exceptions where a protocol has been ineffective or causes or would cause harm to a beneficiary, without penalty to that beneficiary.
(Regulation 15H inserted by regulation 14 of Government Notice R1360 in Government Gazette 24007 dated 4 November 2002.)
15I. Formularies
(c) provision must be made for appropriate substitution of drugs where a formulary drug has been ineffective or causes or would cause adverse reaction in a beneficiary, without penalty to that beneficiary.
Thank you
15 H. Protocols
If managed health care entails the use of a protocol -
(c) provision must be made for appropriate exceptions where a protocol has been ineffective or causes or would cause harm to a beneficiary, without penalty to that beneficiary.
(Regulation 15H inserted by regulation 14 of Government Notice R1360 in Government Gazette 24007 dated 4 November 2002.)
15I. Formularies
(c) provision must be made for appropriate substitution of drugs where a formulary drug has been ineffective or causes or would cause adverse reaction in a beneficiary, without penalty to that beneficiary.
Thank you
Bonitas Medical Fund's replyOfficial
31 Aug 2020, 08:41Hello Hansraj S,
Thank you for submitting a comment to us through Hellopeter.
According to the email communication, we hereby confirm that your concern has been addressed and this matter has now been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concerns to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Thanks and regards,
Bonitas Team
Bonitas Medical Fund's reply31 Aug 2020, 08:41
Official
Hello Hansraj S,
Thank you for submitting a comment to us through Hellopeter.
According to the email communication, we hereby confirm that your concern has been addressed and this matter has now been resolved.
As Bonitas we strive to give the best customer service to our clients and appreciate it when you bring your concerns to our attention when we have failed to deliver this service.
We apologise for any inconvenience caused to you.
Thanks and regards,
Bonitas Team