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Claims

Claims can be submitted through the Member App, Member Zone, WhatsApp or via email at claims@bonitas.co.za.

The Medical Schemes Act requires valid claims to be paid within 30 days of being received. However, Bonitas processes claims every week, which means that valid claims are often paid well before the 30-day deadline.

Stay updated on your claim status through the Member App, Member Zone, WhatsApp.

AUTHORISATIONS

  • Membership number
  • Date of admission
  • Practice number of hospital
  • Practice number of doctor
  • ICD-10 codes
  • Procedure codes
  • Dependant code

Our channels to obtain authrisation include the call center, email and the provider zone for providers.

BILLING

Utilise the following channels to contact us:

  1. Call 0860 002 108
  2. Chat to an agent on our WhatsApp line 076 172 3151
  3. Email queries@bonitas.co.za with your membership number and bank statement

MATERNITY

  1. Register for the Maternity Programme by calling 0860 999 121
  2. Request an antenatal authorisation
  3. Request a delivery authorisation

Please submit the query through the applicable member or broker claims escalation channel.

Include the following information:

  • membership number
  • claim number
  • medicine details
  • date of service and supporting documentation where applicable

CHRONIC

Where a medicine was previously fully covered but is now attracting co-payment, it will be reviewed.

For review, please submit the following information through the applicable member or broker claims escalation channels:

  • membership number
  • medicine details
  • date of service and supporting documention where applicable

The formulary is subject to clinical benefit and commercial review, and updates may occur when there are changes in medicine availability such as:

  • new medicines or alternatives becoming available
  • pricing
  • clinical evidence or
  • other benefit considerations

FREQUENTLY ASKED QUESTIONS

How can I find a Provider on the network?

To find a provider on your network, you can use the Bonitas Provider Locator available on the Member Zone and Member App. This tool allows you to search for doctors, specialists, hospitals, and pharmacies within your network.

What is the Benefit Booster allocation?

It’s an additional benefit amount that can be used to pay for eligible out-of-hospital claims once activated. Check your plan brochure to see your available Benefit Booster allocation and the actions you need to complete to fully unlock your benefit.

How to add a dependant?

You can add a dependant by completing a ‘change of dependant’s form’. The form is available from your broker, your nearest walk-in centre or your Human Resources department if your medical aid is provided through your employer.

How do I check my available benefits?

You can access your benefits on the following digital platforms:

  • Member App
  • Member Zone

These platforms give you a clear view of all the benefits available to you.

Where can I update my personal details?

You can update your details by logging in to the Member App, then tap on the menu icon and select ‘Membership’. Tap on the ‘Contact’ dropdown and edit the details you’d like to update.

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2027 HIGHLIGHTS

See all brochures designed to enhance flexibility for members in managing their day-to-day healthcare expenditure.

WHAT'S NEW?

WALK-IN CENTRES

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Operating Hours
Monday to Friday: 08:00 – 17:00
Saturdays: 08:00-12:00 (Selected branches only)
Sundays & Public Holidays: Closed

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