Paid for Coverage, Denied at Network Doctor – Bonitas Response: Cancel

My fiancé moved to Bonitas last year and carefully went through all available plans with a consultant. During this process, she specifically confirmed which hospitals and doctors were covered before choosing a plan that suited her needs.

Last week, she visited a doctor’s practice that is listed as covered according to Bonitas’ network information. However, when the practice submitted the claim, Bonitas rejected the consultation, and we were required to pay out of pocket.

When she went to collect the medication prescribed by the doctor, all items were also declined by Bonitas.

This is extremely concerning. We made a deliberate effort upfront to confirm network providers and ensure the correct plan was selected. Yet when using a listed provider, both the consultation and medication were rejected without a clear explanation.

To make matters worse, when we contacted Bonitas to query the issue, the consultant did not attempt to assist, review the plan, or provide guidance. Instead, we were told that a cancellation letter would be sent. There was no attempt to resolve the matter or explore a solution.

We expect the consultation fee and prescribed medication to be covered, as outlined in the medical plan we are paying for. If Bonitas is not willing to honour the benefits of the plan and provide the service contracted for, then we require a full refund of all payments made to date.

We hope Bonitas will address this matter transparently and provide a fair resolution.