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nicholas N

1 reviews | Active since Jun 2017

23 Jun 2017, 11:56

Worst medical aid in SA

<p>In Feb this year My mum was diagnosed with breast cancer and had to have an emergency mastectomy to remove the cancer , which thanks to God An excellent doctor , she is cancer free , how ever this medical aid is the most unhelpfull medical aid that i have delt with , in april they rejected the claim because they processed it as out off hospital benefit , when i phoned in 3 seperate times before they had realised that it was in hospital , now its is june and i get a bill form the doctor where the medical aid has short paid them by R2500 , when i call to find out what has gone on they tell me , that because it was a planned operation they cant cover the full amount, if we did not get any authorisation and just went in for teh surgery they would off covered it , how can you plan to get breast cancer ?? i followed the correct steps and got authorisation before they admitted my mother , which to them makes it seem like i planned for her to get breast cancer and have this operation done , i phoned again and no 1 seem to understand what we went through and all they say is it was a planned operation so they cant cover the full amount </p>

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Replies (1)
Bankmed
Bankmed's reply26 Jun 2017, 14:23
Official

Dear Nicholas

Thank you for allowing us to look into the matter.

We have confirmed that the claim in question was processed correctly as per member's plan type, we have sent you an email with the details and you may respond directly to it for further assistance on this matter.

Regards

Bankmed Servicing Team