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Faith B

1 reviews | Active since Jul 2016

07 Feb 2019, 10:29

Medical Aid refuse to approve much needed medication.

I need urgent guidance and advice Please?? Last year I was diagnosed with MDAD and was admitted. My Psychiatrist prescribed me medication for my condition. I have been straggling for the past few weeks with the medical aid with regards with approving the medication on Chronic? My doctor have send the chronic dept. an motivational letter however it was rejected twice?

On the 21st Jan I went to Clicks Pharmacy to collect my medication and my was told that the it will not be covered on chronic or from my day to day benefit as it show that there is no funds available? It's January? How can i not have any funds I then left Clicks as I didn’t have cash for my medication (I only had 3 day’s medication left at the time). I called Chronic management the spoke to Kobuso ( Ref no: 010219Q7867N) he confirm that I still had funds and that and that he was gone escalate the query and call me back? I never got feedback? I have send emails ? no responses was received? the no- rely emails - I called again and spoke to Nerishnee (Ref no: ********** 78746) – said I can collect my meds and asked the pharmacist to claim the meds from acute medication, my claims was rejected again.??? I then called again and spoke to Dingtle (Ref no: 010219Q790DB) She was very helpful (thanks dear). She got a team leader involved and investigate my query and called me back and said that due to the fact that I was on Standard Select last year that did cover my meds and this year I am on Primary Select that didn’t cover my medication the system is rejecting it. I had to add my 2nd child on my medical aid and the Standard Select plan was to expensive and that is why I changed to Primary Select. They needed to go in my Standard Select account and needed to cancel it and only then it can be claimed on Primary select as acute. She suggested that I maybe go get the medication and pay for it since I have been off my meds for days and claim it back? I went again to Clicks and the pharmacist said that the medication needed to be approved in order for me to claim my money back......... Once again I had to go home with nothing!! I decided you wait till I hear from Dingtle because I didn’t budget for this extra expenses. Monday I have no feedback? ( I decided to wait another day for them to sort things out) But on Tuesday I had called and asked to talk to Dingtl, she was also awaiting feedback and called me just before 16h00 to advise me that it was now fix on the system and that I can go and collect the medication. I should asked them to reverse the previous claims and it should go of my day to day benefit and if it doesn’t go off acute the pharmacist should call the claims department. It didn’t work again!! CLICKS called claims dept. and they were unable to help. (Ref.no:050219Q7HT0J) and told the pharmacist that I should call Chronic Management myself?! Bonitas was already closed at that time................. The pharmacist was very upset with me and told me every time they reverse the claims the have to pay for it? They don’t want to help me anymore? Yesterday morning I called Dingtle again and she informed me that Primary Select does not cover Depression!!! – so in short the medication that I so urgently need can only be covered under CHRONIC and i can not get it from my day to day benefit! Bonitas Medical Aid Rejected my medication on chronic and I will have to pay cash each month for my medication. That’s on top of paying a monthly premium .It’s been 14 days that I have been off my medication have been going through withdrawal again. I am so afraid I will relapse and urgently need someone to help me. I have spent money on calls, petrol and time going to Clicks for weeks on to be told all this!! I send a personal motivation to the Chronic department last nigh and are awaiting feedback. My last hope will be to cancel with Bonitas and find an medical aid that can cover my condition and is still affordable.

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Replies (1)
Bonitas Medical Fund
Bonitas Medical Fund's reply07 Feb 2019, 16:48
Official
Hello FaithBr,

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 apologise for any inconvenience caused to you.

Kind regards,                           

Bonitas Team