EM
Eugene M
1 reviews | Active since Apr 2021
08 Jun 2021, 05:03
Affinity Health Requests me to personally pay R100 000.00 Upon my Hospital Admission and Would not provide any Further Cover for my Injury
A number of medical schemes provide full hospital with prescribed minimum benefits for under R1500 which I have been paying Affinity since 2019. Secondly, Affinity has approved my hospital claim and demand for me to pay from my own pocket the full amount of R100 000.00 requested by the hospital. Thirdly, I am forced to use public hospitals while paying my monthly cover because my funds are depleted. Fourth, Prescribed Minimum Benefits (PMBs) are not applicable at Affinity Health. PMB's are a set of defined benefits to ensure that all medical scheme members have access to certain minimum health services, regardless of the benefit option they have selected.
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Replies (3)
Affinity Health's replyOfficial
08 Jun 2021, 08:55Good day Eugene M
Thank you for raising your concerns with us.
We can confirm that the Complaints Department has been in continuous communication with you.
Affinity Health has been transparent regarding the benefits available on your plan and how the benefits work.
Should you require any further clarity or assistance regarding the matter, please let us know and we will gladly assist.
Kind Regards
Affinity Health Management Team
Affinity Health's reply08 Jun 2021, 08:55
Official
Good day Eugene M
Thank you for raising your concerns with us.
We can confirm that the Complaints Department has been in continuous communication with you.
Affinity Health has been transparent regarding the benefits available on your plan and how the benefits work.
Should you require any further clarity or assistance regarding the matter, please let us know and we will gladly assist.
Kind Regards
Affinity Health Management Team
EM
Eugene M's updateReviewer Update
08 Jun 2021, 11:07Hi All,
How can a member be expected to pay upfront an amount of R100 000.00 to a hospital when he is informed that his claim is approved. The hospital requested upfront payment and Affinity just passes the buck to the member client.
This site is used to warn and encourage clients about companies and service providers experiences.
The public out there be warned that Affinity Health is not a medical scheme. I was a member of Discovery before joining Affinity Health. I am single member and my contribution is just over R1500.00 per month for their premier plan, the Combined. I have been injured since December and Affinity only paid for my hospital stay for 8 days only. I have been forced to use public hostels as Affinity Health claims my cover is depleted.
They happily discharged the accident benefit of R175 000 upon my accident and when that was depleted, they would not release the hospital cover. They gave me a waiting period of 6 months before I could access the hospital cover funds. Why is there a waiting period between the accident and hospital benefits as often they are required urgently.
There are number of schemes available for under R1500 where the Prescribed Minimum Benefits are provided to ensure that members have access to certain minimum health services, regardless of the benefit option they have selected.
For small medical claims Affinity Health would be sufficient but they would literally kick you while you are down while being a good standing member in need of their support. For example, how can they approve a claim and expect a member to pay the service provider R100 000 in advance?
I would never recommend Affinity Health to anyone, even my worst enemy
How can a member be expected to pay upfront an amount of R100 000.00 to a hospital when he is informed that his claim is approved. The hospital requested upfront payment and Affinity just passes the buck to the member client.
This site is used to warn and encourage clients about companies and service providers experiences.
The public out there be warned that Affinity Health is not a medical scheme. I was a member of Discovery before joining Affinity Health. I am single member and my contribution is just over R1500.00 per month for their premier plan, the Combined. I have been injured since December and Affinity only paid for my hospital stay for 8 days only. I have been forced to use public hostels as Affinity Health claims my cover is depleted.
They happily discharged the accident benefit of R175 000 upon my accident and when that was depleted, they would not release the hospital cover. They gave me a waiting period of 6 months before I could access the hospital cover funds. Why is there a waiting period between the accident and hospital benefits as often they are required urgently.
There are number of schemes available for under R1500 where the Prescribed Minimum Benefits are provided to ensure that members have access to certain minimum health services, regardless of the benefit option they have selected.
For small medical claims Affinity Health would be sufficient but they would literally kick you while you are down while being a good standing member in need of their support. For example, how can they approve a claim and expect a member to pay the service provider R100 000 in advance?
I would never recommend Affinity Health to anyone, even my worst enemy
EM
Eugene M's update08 Jun 2021, 11:07
Reviewer Update
Hi All,
How can a member be expected to pay upfront an amount of R100 000.00 to a hospital when he is informed that his claim is approved. The hospital requested upfront payment and Affinity just passes the buck to the member client.
This site is used to warn and encourage clients about companies and service providers experiences.
The public out there be warned that Affinity Health is not a medical scheme. I was a member of Discovery before joining Affinity Health. I am single member and my contribution is just over R1500.00 per month for their premier plan, the Combined. I have been injured since December and Affinity only paid for my hospital stay for 8 days only. I have been forced to use public hostels as Affinity Health claims my cover is depleted.
They happily discharged the accident benefit of R175 000 upon my accident and when that was depleted, they would not release the hospital cover. They gave me a waiting period of 6 months before I could access the hospital cover funds. Why is there a waiting period between the accident and hospital benefits as often they are required urgently.
There are number of schemes available for under R1500 where the Prescribed Minimum Benefits are provided to ensure that members have access to certain minimum health services, regardless of the benefit option they have selected.
For small medical claims Affinity Health would be sufficient but they would literally kick you while you are down while being a good standing member in need of their support. For example, how can they approve a claim and expect a member to pay the service provider R100 000 in advance?
I would never recommend Affinity Health to anyone, even my worst enemy
How can a member be expected to pay upfront an amount of R100 000.00 to a hospital when he is informed that his claim is approved. The hospital requested upfront payment and Affinity just passes the buck to the member client.
This site is used to warn and encourage clients about companies and service providers experiences.
The public out there be warned that Affinity Health is not a medical scheme. I was a member of Discovery before joining Affinity Health. I am single member and my contribution is just over R1500.00 per month for their premier plan, the Combined. I have been injured since December and Affinity only paid for my hospital stay for 8 days only. I have been forced to use public hostels as Affinity Health claims my cover is depleted.
They happily discharged the accident benefit of R175 000 upon my accident and when that was depleted, they would not release the hospital cover. They gave me a waiting period of 6 months before I could access the hospital cover funds. Why is there a waiting period between the accident and hospital benefits as often they are required urgently.
There are number of schemes available for under R1500 where the Prescribed Minimum Benefits are provided to ensure that members have access to certain minimum health services, regardless of the benefit option they have selected.
For small medical claims Affinity Health would be sufficient but they would literally kick you while you are down while being a good standing member in need of their support. For example, how can they approve a claim and expect a member to pay the service provider R100 000 in advance?
I would never recommend Affinity Health to anyone, even my worst enemy
Affinity Health's replyOfficial
09 Jun 2021, 12:47Good day Eugene M
As mentioned to you, we have agreed to cover the amount of R125,000 according to your benefit available on your plan. This amount will cover the service providers such as the surgeon, anesthetist, radiology, pathology and other treatment required.
Please note that Affinity Health cannot cover for the same event from more than one benefit within a 6 month period, which is the reason why there was a waiting period before the Daily Illness benefit could be authorised, as your Accident benefit was depleted.
It is also important for our members to review their medical conditions as well as benefits available on a regular basis to ensure that the medical cover they choose is best suited to their medical needs.
Kind Regards
Affinity Health Management Team
Affinity Health's reply09 Jun 2021, 12:47
Official
Good day Eugene M
As mentioned to you, we have agreed to cover the amount of R125,000 according to your benefit available on your plan. This amount will cover the service providers such as the surgeon, anesthetist, radiology, pathology and other treatment required.
Please note that Affinity Health cannot cover for the same event from more than one benefit within a 6 month period, which is the reason why there was a waiting period before the Daily Illness benefit could be authorised, as your Accident benefit was depleted.
It is also important for our members to review their medical conditions as well as benefits available on a regular basis to ensure that the medical cover they choose is best suited to their medical needs.
Kind Regards
Affinity Health Management Team