Bonitas: Members report ongoing issues after largest admin change in South Africa
- Bonitas claims that their service is stabilising post-administration transfer, but issues persist for many members
- Delays in claims processing and authorisation continue, affecting vulnerable members the most
- Bonitas emphasises financial strength, yet lacks clear timelines for resolving outstanding member issues
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Bonitas claims that service is stabilising after a massive admin switch – but members, including myself, still report unresolved problems.
More than two months after the largest medical scheme administration transfer in South African history, Bonitas Medical Fund says operations are improving and that service challenges currently affect fewer than 10% of members. Yet complaints about delayed or unpaid claims, incorrect deductions from medical savings accounts, long call-centre waits, system failures and difficulties obtaining authorisations continue to surface.
This article was prompted by my own experiences as a Bonitas member. Since the transition I have encountered persistent service and claims-processing difficulties. If someone in a position to escalate and push for answers is still facing these problems, the situation is likely far more difficult for members living with chronic conditions or those less able to navigate complex systems and fight for resolution.
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On 1 June 2026, Bonitas moved administration from Medscheme to Momentum Health Solutions and managed care to Private Health Administrators (PHA). The change affected more than 750 000 beneficiaries. Almost immediately, members reported problems obtaining hospital and specialist authorisations, accessing chronic medication, reaching support channels, using digital platforms and viewing medical savings balances. Some procedures were postponed. The Council for Medical Schemes received dozens of complaints in the first month, several treated as urgent. Public complaints on platforms including Hellopeter and X have continued into August.
Briefly News put five questions to Bonitas regarding the scale of the problems, plans to resolve outstanding claims, support for vulnerable members, failures in escalation channels, and steps to restore member confidence.
Bonitas response
Nechia Khuzwayo of Tribeca Public Relations responded on behalf of the scheme.
On the scale and causes of the problems, Bonitas described the change as the largest of its kind in the industry, impacting over 750 000 beneficiaries and requiring significant operational coordination. Since implementation the scheme has processed more than R3 billion in claims, R9.8 million in savings refunds and R74 million in broker commission payments, while handling more than 500 000 customer calls, over 60 000 chats and more than 400 000 emails. It stated that concerns currently impact less than 10% of the member base. Bonitas, Momentum Health Solutions and PHA have been working together to stabilise operations and report notable improvements in claims, chronic authorisations and managed care servicing.
On concrete plans and timelines for outstanding claims, particularly maternity and chronic care cases, the scheme said resolving member queries and restoring normal service levels remains the immediate priority. Dedicated teams are working around the clock. Additional resources have been deployed, processes refined and focused interventions put in place for urgent and clinically sensitive cases. Clinically urgent or complex cases are escalated to clinical teams. No specific deadlines or completion targets were given. Bonitas emphasised its financial position: a record R1.8 billion surplus for 2025, R10.8 billion in liabilities to members for future benefits, a 36.9% solvency ratio and an AA+ credit rating.
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Addressing support for vulnerable members, including pregnant women and those with chronic or life-threatening conditions, Bonitas said particular attention is being given to clinically sensitive cases. These are escalated to clinical teams for priority review. Additional support capacity has been introduced, collaboration with healthcare providers strengthened and operational monitoring enhanced. Members requiring maternity support are directed to the Maternity Programme helpline on 0860 999 121.
Bonitas noted the failures in internal escalation channels, and said member support and escalation processes continue to be reviewed and strengthened. Customer service contact points have been enhanced and a dedicated escalation email address - escalations@bonitas.org.za - has been introduced for members experiencing life-threatening or clinically urgent access-to-care challenges.
On communication and accountability, Bonitas pointed to a dedicated Transition Hub on its website, enhanced monitoring and dedicated service channels. It acknowledged that rebuilding trust requires more than statements and depends on measurable improvements in service delivery. The scheme, together with Momentum Health and PHA, said it remains committed to resolving the remaining transition-related challenges as quickly as possible.
Scale versus lived reality
Bonitas’ processing volumes and financial strength are significant. Handling billions in claims and hundreds of thousands of contacts while managing a transition of this size is a substantial task. The scheme’s solvency and surplus figures are not in dispute.
What remains missing are clear timelines for resolving outstanding claims. A claim that fewer than 10% of members are affected still leaves tens of thousands of people potentially impacted. Public platforms continue to reflect the same pattern of complaint that began on 1 June 2026: unpaid claims, incorrect savings deductions, unanswered queries and difficulties securing authorisations.
The scheme now promotes a dedicated escalation email for urgent cases and directs members to its website for accurate contact information. Earlier member reports indicated that some previously provided escalation routes did not function. Without firm, time-bound commitments, members are left without certainty about when remaining problems will be fixed.
As a member who has personally struggled with these issues, our concerns are straightforward; if the system is difficult to navigate for someone able to escalate and pursue answers, the consequences are likely more severe for those with chronic or complex conditions and those with fewer resources to keep pushing.
Bonitas, Momentum Health Solutions and PHA say clinically urgent cases are prioritised and extra resources have been deployed. However, the real measure will be whether outstanding claims are paid, authorisations are issued timeously, and support channels work reliably for ALL members.
We will have to wait and see.
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Source: Briefly News
