Disappointed Member

Bonitas proud themselves by saying that "So you know we have you covered" but this seems just to be a marketing ploy to get more members.

My husband was diagnosed with renal cell carcinoma in 2016 which has over the last couple of years metastasized to multiple areas. He has been registered on the oncology program since 2016.

His last surgery was in June 2023 to alleviate his pain and symptoms associated with the RCC. It was a extremely tiring and demanding procedure due to the complexity and dangerous position of the tumor. The operation lasted for five and a half hours with unforeseen complications leaving my husband on a ventilator for almost two days.

This has now left us with a major unpaid bill from the anesthesiologist . We took care to try and use network specialist but that is not always possible. No patient going for surgery chooses their anesthetist, we only met him on the day of the surgery shortly before going into theater.

Bonitas is saying that that we are liable for the shortfall as the anesthesiologist is not part of their DSP arrangement and that they charge above medical aid scheme rates.

I feel there is a huge gap in the this particular area that Bonitas should be looking at because we as members of a medical aid do not have the bargaining power to negotiate rates with anesthesiologists. Making matters worse is the unwillingness or inability of medical aids to address the rates that these providers charge - I was informed by Bonitas' client services that it is the patient's responsibility to negotiate rates with them and not the medical aid. If that's the case, why are we paying such high member's contributions?

Client services forwarded me the providers list on the anesthetist network and there were not one anesthesiologist listed to be active at the hospital were my husband was operated and only one in the close vicinity. Bonitas should the very least ensure accessibility of DSP anesthesiologists and advise their members accordingly.

My husband's surgery should have been considered under "palliation / symptom control" which is a PMB condition. Where surgery is performed for a PMB condition, the anesthetist should be paid in full whether a DSP or not. I was advised that the anesthesiologist would have been paid in full if the operation was deemed as an emergency - so my husband's quality of life is of no consideration?