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JJ
Johan J

1 reviews | Active since Dec 2010

10 Oct 2024, 14:08

Stopped Payments of Claims with sublimit left.

I moved to Bonitas from Discovery last year, after confirming that they have a benefit. They paid the benefit up to May and I am still trying to get claims paid for the same benefit after that. I have not reached my sublimit yet on the benefit, but they refuse to pay and send you around in circles. I have checked the sublimits.

I climbed on to their plan and now they have stopped payment for claims. Very disappointing. They will send you to the chronic department, but the chronic department doesn't deal with the day to day sublimits, but they will still do it and be adamant that you should go to chronic, which just will decline you, since it's not a PMB but a benefit on the plan. Almost 6 months and out of pocket. Don't believe everything they tell you.

0
Replies (16)
Bonitas Medical Fund
Bonitas Medical Fund's reply10 Oct 2024, 14:23
Official
 
Hello Johan

Thank you for notifying us of your complaint. We are so sorry to hear about this, we are glad that you brought this to our attention to resolve. 
 
We will investigate this matter. 
  
We appreciate your patience while we are resolving this query for you. 
 
Kind Regards 

Bonitas team 
JJ
Johan J's update10 Oct 2024, 14:29
Reviewer Update
Thanks for the reply. It is Thursday 10 October. It looks automated. Has a human seen this complaint?
Bonitas Medical Fund
Bonitas Medical Fund's reply10 Oct 2024, 14:42
Official
 Hello Johan

Thank you for notifying us of your complaint. 
 
We will investigate this matter. 
  
We appreciate your patience while we are resolving this query for you. 
 
Kind Regards 

Bonitas team 
Bonitas Medical Fund
Bonitas Medical Fund's reply10 Oct 2024, 16:16
Official
 
Hello Johan

Thank you for notifying us of your complaint. 
 
We will investigate this matter. 
  
We appreciate your patience while we are resolving this query for you. 
 
Kind Regards 

Bonitas team 
JJ
Johan J's update02 Dec 2024, 09:33
Reviewer Update
Waiting forever to get my issue resolved. They stopped paying in May already for my consumables...

I have made so many calls it's ridiculous and you can never get past the call center to someone who can resolve your issues. They will post a bot response below this complaint:
Bonitas Medical Fund
Bonitas Medical Fund's reply02 Dec 2024, 11:03
Official
Hello Johan

Thank you for notifying us of your complaint. 
 
We have escalated your query to chronic department for further investigation.
  
We appreciate your patience while we are resolving this query for you. 
 
Kind Regards 

Bonitas team 
JJ
Johan J's update02 Dec 2024, 11:24
Reviewer Update
I have already done that multiple times via phone in the last months, since May. I am diabetic and need the things that is taking so long.
JJ
Johan J's update03 Dec 2024, 11:27
Reviewer Update
I have phoned again today and they are still waiting for feedback. My reference is 031224QNJ066

I have not yet received a positive outcome on this query. Could you provide me with feedback or an ETA?
JJ
Johan J's update04 Dec 2024, 12:26
Reviewer Update
I followed up today again: 041224QNL9JF and ther is still no feedback. Do you have any ETA for me on when they will authorise my medication?
JJ
Johan J's update05 Dec 2024, 15:12
Reviewer Update
I have followed up again. Today is the 5th of December. I am hoping to get my medication before I go on holiday. It has been a long few months to get this sorted. My new reference number for today's follow-up is 051224QNP2VK. Do you maybe have any feedback yet on this query? It is still the same query as before that is still unresolved.
JJ
Johan J's update06 Dec 2024, 14:52
Reviewer Update
I am just following up again, It doesn't look like my issue is getting resolved. Please can you make sure that someone is attending to it. I am not sure who is responsible, as I can only speak tot he call center. The reference for the call was 061224QNRNW7 and it is still the same issue as before.

Please can I get feedback on my application?
Bonitas Medical Fund
Bonitas Medical Fund's reply06 Dec 2024, 17:52
Official
Hello Johan

We sincerely apologise for any inconvenience you may have experienced due to the delay in resolving your query. 
 
Kindly note that we are waiting for feedback from Tenda Health.
  
We appreciate your patience while we are resolving this query for you. 
 
Kind Regards 

Bonitas team 
JJ
Johan J's update09 Dec 2024, 12:31
Reviewer Update
Thanks for the feedback, but I still didn't get the answer for my medication. I have a new reference number for today: 091224QNT9SB. Please can you escalate it again like every day last week over the phone. It is very urgent. It is a long time to wait for chronic approval.
JJ
Johan J's update10 Dec 2024, 16:49
Reviewer Update
Today I spoke to Lynn Peterson at Bonitas and am still waiting for feedback. Please can you give me feedback on this chronic request.
JJ
Johan J's update13 Dec 2024, 10:40
Reviewer Update
I am still waiting for feedback on this authorisation. It is now very long since I try to follow up daily so that it gets done. Please give me the authorisation the phone reference is 131224QT1XZR. How long will it still take? It is almost Christmas and I need the meds preferrably before going away and before you guys close. Is there any feedback except "it has already been escalated"?
JJ
Johan J's update24 Jan 2025, 15:46
Reviewer Update
I was denied my authorisation for my diabetic consumables, even after applying through the chronic process. I have put in a complaint with the Council for Medical Schemes to see if they will resolve it for me favourably.

Hopefully a third party can bring some solution to the table.