*********** people

On the 28th of December 2019 I rushed my 2 year old daughter to the Emergency room at Die Wilgers Hospital, as there was literally no Doctor’s Consultation Rooms open at the time. My child had a urinary tract infection, and with me being a mom that can obviously not stand back and watch my child complain and cry at the same time that it hurts when she has to pee , I went to a pharmacy to find out if they can give me something over the counter that can assist, but unfortunately they advised that we need to get to a doctor as she would need an antibiotic. As explained above there was no doctor’s open, we drove around the city for almost 2 hours and after that did not have a choice but to go to the hospital. Guess what, the Medical aid did not pay, as always. I had to pay the hospital R694 consultation fee and the and the prescription that the doctor gave for her medicine amounted to R315. The explanation I received from Bankmed is that I get 3 out of network visits to the Value of R2500 and if I go to the hospital at the emergency room it should fall under out of Network cover, but I have used up my out of network benefit which was 3 visits but I have not user up the R2500, the 3 out of network visits that I can calculate does not even amount to R1000, my question is where is the rest of the R2500, surely in a case of emergency you can allocate the funds for the member to be helped. I definitely do not agree with how this medical aid is working , I feel it is unfair and is always looking for ways not to pay. This was an emergency, emergency , how do you not cover such. You need to be ashamed of how you conduct your business, you will lose ample business because of this trend. I’m very unhappy, and I want a refund. I cannot be paying R4558 per month for bankmed to reject 50% of claims. Hoe just how?