GROSS MISREPRESENTATION / POOR SERVICE

I would just like to document my terrible experience with Bonitas Medical Aid. I had recently upgraded my plan from Bonstart Plus to Bonitas Primary Select due to procedures I required that was not covered by the scheme. The following transpired:-

My doctor has tried authorizing the procedure after I changed my plan and it was declined and a letter of motivation was required – this was already submitted when I changed my plan. I was confused. I personally called the medical aid to enquire on same and they advised that the auth was done on the incorrect plan DESPITE MY DOCTORS ROOMS GIVING THEM THE NEW MEMBERSHIP NUMBER– the plan was corrected and the auth was approved. I was advised by the consultant that a 30% co-payment would apply as I’m selecting to do the procedure in a hospital rather then a day clinic and the hospital is further a non-DSP.I was advised that the co-payment will be R2430.00 – taking into account the scheme rules I had agreed to proceed with due regard to the co-payment.

I recalled the medical aid again that same day to double check that the only co-payment for the procedure I would have is the amount of R2430 – a second consultant confirmed same. Due to unforeseen circumstances the date of the procedure has to be rescheduled – when my doctors rooms tried redoing the auth we were advised that R2430 was the incorrect amount – the co-payment would actually be R4800.00!!!! THIS WAS A GROSS MISREPRESENTATION OF MATERIAL FACTS! – I was blinded sided by the utter incorrect information I was provided. I am unable to comprehend how the scheme could make such a gross misrepresentation despite me calling twice and speaking to two different agents. If I had proceeded to go through with my procedures I would have had to pay the hospital close to R5000.00 when I had only budged R2400. This was apparently due to the fact that the agent quoted me a copyamnet on the incorrect scheme. Authorization letters were already computed etc. No one had even bothered to advise me of this and/or recall the letters submitted - i was informed of this by my doctors rooms rather then the medical aid.

Apart from the abovementioned I was billed an additional R700 this month – I was advised that my new medical plan kicked in from 1/8/23 however I had only received my confirmation for the plan change on 23/8/23. I had no access to the new plan benefits as it was still being reviewed and approved – so I was basically billed for a full month on a new plan that was still being authorized to change. I requested feedback on this and i wasn't given a straight answer despite me advising that the plan change was approved at the end of the month.

Every step of the way I’ve had issues this is far by the worst medical aid and customer service received was nothing short of putrid and disturbing. I would urge anyone looking for good health cover to avoid bonitas at every cost rather stick with the well known schemes like Discovery. Bonitas systems and processes seem outdated. Their customer service replies are non-compassionate and very generic. Agents lack problem solving skills

This is just the first of many issues i've had with bonitas.