PMB Condition (26 Chronic Conditions) Application runaround from Bonitas

I joined Bonitas in July 2021, through a broker, Chi. Prior to join Bonitas I was on other medical aids and did not have interruption of more than 90 days at any given point.

I was diagnosed with one of the 26 PMB chronic condition in January 2019 and my I app**** for the chronic condition with previous medical aid and was covered as a PMB condition.

My frustrations started when I app**** for the PMB condition with Bonitas at the end of July 2021. Firstly, there isn’t a contact number for PMB, there’s only an email address. Secondly you are told the turnaround time is 48 - 72 hours for response on PMB Application which is not true at all.

I app**** through the email to *** on the 22nd July 2021, got an automatic response & reference number same day. I got a response a few days later saying I need to submit documents and letter of motivation. My doctor did so on the 28th July 2021. I followed up on the 05th August 2021, no response. I followed up again on 10 August, no response. On the 12th August, 14 days later after 2 follow ups, I received a response saying “Kindly note member is not registered for chronic, care plan requirement is chronic medicine authorisation”, whatever this means. I got another email from my broker, after also trying so hard to get his help but to no help, forwarded from The ambulatory PMB team saying “ The following benefit request has not been authorised as Prescribed Minimum Benefit (PMB) as the criteria for funding has not been met. More clinical information is required from the treating health care provider.”

I then sent an email AGAIN on the 19th August 2021 applying for the PMB condition, attaching 11 documents which included prior hospitalisation, sick notes, previous medications prescription, previous PMB applications and acceptance, previous treatment plan and letter of motivation from my doctor, a specialist “enough clinic information”. Yet again, got an automated response with reference number on the same day. I made a follow up on 25th August, we’ll after 72 hours of not receiving response, no response yet again. Made a follow up on the 30th August, guess what, NO RESPONSE yet again. Spoke to my broker again, who is also not much help, and he said my application was rejected because there’s no letter of motivation. The same letter of motivation that was attached both times when I app****!

Over a month since I app**** for PMB Condition Benefit, I still don’t have any response from Bonitas. I am not sure if they want to see my dead body first and that will serve as sufficient motivation for them to approve my PMB benefit. I never struggled like this with my previous medical aid. Had it not been a closed scheme and was not attached to my previous job, I would still be on it. Bonitas is the WORST medical aid. Why am I getting the runaround for a PMB Condition that the previous medical aid covered me on. I would not recommend Bonitas to anyone!