The Council for Medical Schemes (CMS) has received 46 complaints from Bonitas members following the medical scheme’s change of administrators and managed-care providers on 1 June, with two cases considered sufficiently urgent to warrant the regulator’s expedited investigation process.
Within days of the 1 June transition, Bonitas’s social media platforms filled with complaints from members reporting difficulties obtaining authorisations, accessing chronic medication, reaching support channels, and using the scheme’s digital platforms.
In its response to Moonstone on 25 June, Bonitas said service levels were “returning to normal levels on a daily basis”. More recent comments posted on the scheme’s Facebook page indicate that some members continue to experience difficulties.
In response to questions from Moonstone, the CMS said the 46 complaints were registered between 1 and 26 June.
The regulator cautioned, however, that the complaints cannot yet be attributed specifically to the post-transition service disruptions.
“The issues complained of date back prior to the scheme’s transition to the new administrator,” the CMS said, adding it would conduct further analysis of the contributory factors as investigations unfold. At this stage, all 46 complaints remain in the early stages of investigation, and complainants have not specifically identified the change in administrator as a factor.
The CMS confirmed it has corresponded via email with both Bonitas and Medscheme Holdings regarding the challenges experienced.
Asked whether it was actively monitoring the situation, the regulator said it was but noted that “the transfer of data is a contractual issue that needs to be managed by the parties concerned”.
Moonstone also asked what powers the CMS has where service disruptions affect members’ ability to obtain authorisations, chronic medication, or other healthcare benefits.
The regulator said that where there is evidence pointing to a contravention of the law, the Registrar of Medical Schemes may issue directives requiring compliance with the law.
Asked whether it had identified concerns that warranted regulatory intervention, the CMS said it is in contact with the scheme, and Bonitas has since communicated a plan to resolve the issue.
“The plan appears to be bearing fruit.”
A difficult start
The complaints follow one of the largest administration and managed-care transitions in South Africa’s medical scheme industry.
Before the 1 June go-live, Bonitas, Momentum Health and Private Health Administrators (PHA) repeatedly assured members, brokers, and healthcare providers that extensive planning, contingency measures, and enhanced governance had been put in place to support the transition. While acknowledging that challenges could arise, they said the focus would be on maintaining continuity of care and responding quickly should problems emerge.
On 1 June, Bonitas transferred its administration from Medscheme to Momentum Health Solutions, while managed-care services moved to PHA.
As Moonstone previously reported, members immediately began reporting problems obtaining hospital and specialist authorisations, accessing chronic medication, reaching call centres, logging into digital platforms, viewing medical savings balances, and obtaining savings refunds. Some reported postponed procedures, delayed treatment, and extended waiting times for assistance.
Read: Bonitas members caught in service disruption after administration switch
The transition also sparked a public disagreement between Bonitas and Medscheme over the causes of the disruption, with Bonitas attributing many of the problems to unresolved legacy matters and data anomalies, while Medscheme maintained it had warned against the “clean-cut” transition approach and had communicated expected query volumes in advance.
Read: Medscheme rejects Bonitas’s explanation for post-transition disruptions
Bonitas: Recovery continues
In its response to Moonstone on 25 June, Bonitas said significant backlogs had been addressed across several key areas, including claims payments and managed-care authorisations.
The scheme said the first batch of claims payments and healthcare provider payment runs had been conducted with positive outcomes and that further payment runs were planned “over the next few days”.
Bonitas also said on 25 June that “service levels are returning to normal levels on a daily basis”, and it had noted “marked decreases over the past week”.
“The vast majority of the backlog has been cleared,” the scheme said, adding that queries requiring additional adjudication represented less than 15% of the initial volumes.
Bonitas also said query volumes had stabilised across several key customer touchpoint channels, and it continued to operate within the requisite regulatory guidelines and adhere to the same, including the necessary scheme rules and governance aspects.
Asked whether complaints to the CMS had increased, the scheme said it had “not seen an influx of these concerns” and would continue responding to queries in line with its standard operating procedures.
Bonitas thanked members for the “grace and patience shown to us during this transition”, apologised for “any inconvenience caused”, and said it would continue to deploy additional resources to ensure it met members’ needs.
Bonitas also said membership levels remained stable.
“While there have been queries raised, our records indicate that the large majority of our members have not experienced any change in proceedings.”
Members say problems persist
Public comments posted on Bonitas’s Facebook page indicate that some members continue to experience difficulties.
The scheme’s most recent Facebook post, published on 17 June, asks members who have paid for healthcare services themselves to email their claims together with supporting documents for reimbursement. Public comments on that post have been restricted.
An earlier post, published on 3 June, remains open and continues to attract complaints, including several posted within the past few days.
One member, Caylin Fortuin, who said she was 38 weeks’ pregnant, described struggling to obtain authorisation for a Caesarean section despite having undergone two previous C-sections.
“I’m literally meant to have my birth on the 2nd,” she wrote. “I’m so scared to go to the hospital because I’m not sure if the hospital will get through to anyone to get an auth no… having a medical aid is meant to give you peace of mind… but the fear and stress I’ve been having while being on my last pregnant has been extremely difficult for me.”
Other recent comments referred to difficulties registering on the new app, accessing prescribed minimum benefits (PMB) care plans, obtaining chronic medication approvals, resolving rejected claims, and reaching consultants through the call centre.
One member recovering from major surgery said claims had been rejected while a chronic medication application remained outstanding.
Another, Deidre Zimri, questioned whether enough was being done to resolve the continuing complaints.
“Is anything actually being done about all these complaints, or are we all just getting the same automated replies?”
She added that members were “begging” for “a proper update and not just another standard response”, while a later post appealed directly to the scheme: “Please hear and read our cries. There can’t be this many complaints without real action being taken… We don’t need more automated responses, we need solutions!!!”
Another member wrote: “Today is the 25th of June and still we are experiencing all sorts of problems from Bonitas since the 1st of June… Smooth transition my foot.”
Additional resources deployed
In a joint statement issued on 25 June, Bonitas, Momentum Health, and PHA acknowledged that challenges had emerged during the early stages of the transition.
The organisations said, “no transition of this scale will happen flawlessly” and expressed the hope that “the worst of it is behind us”, adding that members could look forward to “a more enhanced experience going forward”.
They said more than 600 employees had been appointed, with a dedicated focus on supporting members, resolving queries, and ensuring continuity of care. Dedicated teams continued to work extended hours, while additional resources had been deployed across service channels to resolve outstanding matters.
According to the statement, significant progress had been made in reducing backlogs relating to savings refunds, hospital, and chronic medicine authorisations.
The organisations also said:
- more than 47 000 healthcare providers had been registered on the new Provider Zone, while provider onboarding continued;
- response times on the Bonitas WhatsApp support channel had improved significantly following the clearance of the initial backlogs; and
- more than 40 000 member registrations had been recorded across the Member App and Member Zone.
The statement added that Bonitas, Momentum Health, and PHA had maintained close engagement with healthcare providers, hospital groups, and other stakeholders throughout the stabilisation process. According to the organisations, those engagements had enabled faster identification and resolution of issues and strengthened collaboration across the healthcare ecosystem.
Bonitas, Momentum Health, and PHA said they remained fully aligned in their commitment to members and healthcare providers.
“Our focus remains firmly on supporting members, restoring confidence, and ensuring uninterrupted access to quality healthcare.”
Bonitas has becoming rather pathetic, clients interest doesn’t appear to be a priority. They routinely ignore emails and when they do respond it is “boilerplate” pre-prepared responses (possibly auto generated).
I have lodged a formal complaint at CMS but I’m not hopeful, South African regulatory institutions seem rather toothless in the face of malpractice and more eager to placate the offending body.
As an adviser, it has been a complete nightmare to deal with. It takes weeks on end to receive any feedback for the simplest of requests and tasks. Extremely frustrating and to add to that, multiple email addresses to be used for the same department… ? like why. This is far from being good. It was a massive issue prior to the transitions. it is unfortunately even worse now. You need to piggy back off the DH or Mometum Health systems and implement those. Breeze to work off and with! Clients turn on us eventually for your non operation systems.
This change with Bonitas has been a nightmare, the last 2 months i had to pay thousands of rands cash for things not covered. All of a sudden my chronic heart meds was not covered. My son was admitted into hospital and his CT scan and blood tests had to be paid cash ad they rejected the claims. What is the actual point of paying medical aid if they aren’t going to cover anything?
I am unable to reregister on the member zone. The password format given does not work and despite numerous queries the matter remains unresolved. Furthermore the previous responses to claims submitted ie claim confirmations and claim status reports are not received timeously or not at all. This afternoon members were promised nothing would change. Even my debit order for july had not gone through. Has the administration totally collapsed.
I had the same problem. It turns out that they had my old email address of more than 2 and a half years ago! I eventually after many attempts got through to an agent and during the verification process realized the problem. I am now on the app but my defendant’s details are not there!
Ek en my man moet ook by betaalings doen en medies gou uitgeput en ons as pensioenaris betaal baie n maand en nog by betaalings ook waar ons pensioen minder is as ons medies baie kroniese meds moet ons inbetaaling maak my man hart en long lyer en ek diabetes maagpille het hulle omtrent nooit en stress pille moet ek koop plus my man se bloedverdunnings pille kan nie meer by hou nie
That is not the only problem You are forced to use Marara pharmacy Pathetic they do not understand a 30day cycle They give you your medication every month say on the 28th of that month And that’s it
“Service Levels returning to nornal”. What a blatant, i take you for a fool, lie.
2 weeks to obtain a hospital auth – and still nothing!
I’ve tried every single channel available.
Absolute shambles
I agree Bonitas has been become pathetic, I now need to pay for chronic medication where in the past I didn’t need to. I have sent emails no response
I am also a pensioner!
I’m currently doing enquiries to other medical aids
This new management of Bonita is pathetic. My grandson with epilepsy had to wait from 11am to 17.30 for authorization and still was pending until.next day for admissions. U wait from.45 min to 1hr maybe never for a call to be answered.
I had to pay my chronic meds at the chemist as my number had apparently changed.
I then went to the app and submitted a claim. It did not show as a claim on the app after i was done. I then sent an enail claim 2 weeks ago. I got an answer with a reference but thats it. No refund as yet from 16 June. Bonitas has failed now im afraid. I just hope i dont need to go to hospital soon.
Bonitas is no more the same,I went to pharmacy to get flu medication but I was told that they couldn’t find the quotes because of the changes I became frustrated
I submitted my saving claim on 5th November 2025, the previous administration made so many false promises which they never fulfilled, I was also informed by one of their agent that in January 2026, there was an extension done of which I didn’t not received till now its hide and seek. As from 1/6 I was promised to receive a call from consultants of which it never happened
I wrote 2 complaint letters to them and to CMS nothing is happening
I am a pensioner. Bonitas is just a disgraced medical aid
Why did Bonitas change, only for the clients to end up with problems and Bonitas are very expensive!! Sending me a statement to pay out of the blue, for over R4000?? All of a sudden CO-PAYMENTS for generic medication?? I will find myself another medical aid!!😡
Me and my family can not get our chronic med on chronic because it is not one of the PMB conditions, while before it was no problem. They promised that no benefits will change. You can not speak to anybody the only communication is via e-mail. We need our meds and what has been promised is not being met. Thinking of changing medical aid.
It’s no use, the CMS is biased and no matter what covers the medical aids. I had an issue that continued escalating..the Bonitas said they didn’t pay for the procedure, when I found out some member on the same plan was paid for then they took 4 months to review, then they approved and said I will be reimbursed the following year they said it’s a stake case and cannot reimburse according to the second judgement by CMS. I was with Bonitas for 5 years and was the worst medical aid iv been with.
We were promised that the transition will not affect our current benefits.Not true, my co-payments for my chronic medication has jumped from R30 to R 110.
Momentum has unilaterally replaced the formulary list.One can assume that in the new year, Momentum will change the Bonitas plans.Many will join elsewhere.
True Bonitas is now becoming a different scheme
With marara pharmacy, it’s a nightmare, so unprofessional and they don’t send your medication on time
Who is Marara? I was not advised that I had to use them. Are we now no longer allowed to use the Clicks Pharmacy that I was told to use. Why is there now a co-payment on my generic PMB medication. Why were we told that nothing would change – obviously not true.
Even if you obtained Auth, they still default on payments to providers leaving patients with huge copayments. Fees keep going up, service keeps tanking. Another institution neglecting it’s members to keep shareholders happily overpaid. Disgusting lack of humanity.
Additionally the CMS kept rejecting my complaints because they didn’t like the format of attachments , but even after changing it they still rejected it.
I have ordered my chronic medication from Clicks pharmacy. Yesterday I got told I that I have no day to benefits left. Where I normally pay R168 co- payment [ had to pay the full R460 for my medication . Honestly I am paying R4570 a month. Definitely looking for another medical aid.
A serious Gupta-like investigation need to be undertaken to see who gained financially, when they moved from Medscheme to Momentum. It cannot be done by CMS as they might also be involved.
It’s really an immense change for a very big medical scheme. As a former career person in Bonitas I believe that the service levels will improve drastically. I wish them all the best
I am now more concerned that my complaint will dissappear now thar Momentum has taken over from Bonitas.
I submitted my complaint in January / February 2025.
Although I have followed up with the CMS on a regular basis I still do not have a decision.( 17 months). I am basically “rfobbed off” every time. The CMS SYSTEM does not allow any direct contact with their allocated agent to obtain any feedback.
All I got, month’s ago, was that Bonitas had followed their rules and regulations and thar was that and they considered may case closed. ( COMPLETE Arrogance !!)
Perhaps I will now hear from the CMS . My complaint is that Bonitas’ rules and regulations are unfair and that they also contravene the Consumer Act.
What is happening is deeply concerning.
On paper, Bonitas Medical Fund offers many unique and competitive benefits, but in practice it is becoming increasingly difficult to understand why members would remain on a scheme that is currently so chaotic and operationally unstable.
We have had multiple clients spending hours on calls simply trying to obtain authorisation.
Most concerning was a recent case involving a 4-year-old child diagnosed with Meningitis, where the parents were required to pay approximately R30,000 upfront just to secure admission because the system could not process the authorisation correctly. For a condition that may potentially qualify as a PMB, this is unacceptable.
Our office submitted this member’s application before the transition. After the transition, we were informed that we were not the broker on record. On a separate follow-up, we were then told that the membership could not be found and that the original application did not exist on the system. At the same time, the member could not register on the app because her email address had never been loaded, resulting in critical communication being delayed or missed entirely.
There are clearly multiple breakdowns in this transition process, and unfortunately members are carrying the consequences.
Authorisation was eventually released yesterday, but now the next challenge begins — ensuring that the hospital can navigate and apply the new systems correctly, as providers themselves appear just as uncertain.
We have also had another case where a member submitted a downgrade motivation due to financial hardship shortly before the transition. To date, there has been no progress. Even after visiting the Bonitas walk-in centre, the member was simply told to continue emailing and following up.
The reality is that we are now forced to make multiple calls and send multiple emails just to get a medical scheme to fulfil its basic obligations. This also forces brokers and members to create unnecessary paper trails in the event that a formal complaint needs to be escalated to the Council for Medical Schemes.
Recently, a single call just to obtain feedback on an authorisation took over an hour and a half.
Clients cannot be subjected to this. It is unethical.
As brokers, we can offer valuable advice, support, and advocacy — but when a medical scheme’s systems are fundamentally flawed, it becomes a losing battle for everyone involved, especially the member.
This transition requires urgent intervention, transparency, and accountability from both the Council for Medical Schemes and Bonitas.
Healthcare payments managed centrally on the insurance-based model below 50% from 01.01.2014 – from same privately owned, digital NHI (non-human interface). The hub and spoke risk transfer arrangement.
Why does Bonitas not disclose the financial value of members benefit to members?
Since members benefits payable to registered providers in terms of MSA are approved by the Regulator before the new year starts, and clients of FSP (administrative) providers are schemes and not clinical practices. The comments published above refer to the chaos predicted by BHF in 2012, within the payment of claims to clinical healthcare practitioners: before the 15% vs 85% provider split was imposed.
Savings refund initially done in November 2025 and since then sending repeat documents 5 times, no refund as yet. It seems that the call centre agents are trained like an automated system. They all say the same thing, sorry for the inconvenience, I will escalate but nothing happens. Bonitas is shameful, no matter all the excuses you make in convincing even the CMA, you have put patients lives at risk.
I was a Bonitas member and terminated my membership 31 December 2025. I have sent e-mails, phoned the call centre with no agent attendance after an hour. I requested my Tax Certificate which they keep on taking my details and escalating with no success.
So sick abt this medical aid. Been paying every month but cant even get what’s prescribed to me. They telling me about formula list but still cant authorize medication. Since i used this medical aid I’ve never gotten any help
Bonitas is just a night mare now. The call centre agents dies not answer phones. The monthly statement dies not reflect any information of benefits/benefits used and available.
I had to pay out of pocket for medication and still waiting for my refund.
From what I heard the reason for change over to Momentum, their tariffs are cheaper…. and their service are very poor.
I agree with all of the complaints mentioned here, it’s been almost a month with no replies or aphone call.
WhatsApp not answered.
Bonitas are quick to take my premium. In 13 years being a member I have not experienced such bad service.