BP
Brighton P
1 reviews | Active since Aug 2009
17 Aug 2022, 08:58
Bestmed are the worst
My son(8) had to under a procedure on his gum for an unerupted tooth and Bestmed did not cover the hospital, surgeon and anesthetist. I was told this procedure is not covered on my option. I mean if this is a surgical procedure done in hospital how is it not covered on Beat3? How is it that this not so prevalent procedure is not covered on my option? I had to pay cash for the whole procedure and Bestmed did not even offer to cover for the Doctors atleast. I am disappointed at Bestmed and will surely move to another provide in the new year.
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Bestmed Medical Scheme's replyOfficial
19 Aug 2022, 14:23Dear Brighton,
Kindly be advised that the case was escalated for evaluation and feedback is as follows:
Benefits for elective and planned surgery or procedures abroad shall be subject to pre-authorization, Scheme protocols, and Scheme tariff. The request for procedure was reviewed and we regret to inform you that the service is not funded on your registered benefit option. Funding is based on scheme rules and benefit option funding guidelines and your current benefit option does not cater for this procedure, as such, the scheme is unable to approve the requested service as it is not a registered benefit on this option.
Regards
Katlego Ratau
Kindly be advised that the case was escalated for evaluation and feedback is as follows:
Benefits for elective and planned surgery or procedures abroad shall be subject to pre-authorization, Scheme protocols, and Scheme tariff. The request for procedure was reviewed and we regret to inform you that the service is not funded on your registered benefit option. Funding is based on scheme rules and benefit option funding guidelines and your current benefit option does not cater for this procedure, as such, the scheme is unable to approve the requested service as it is not a registered benefit on this option.
Regards
Katlego Ratau
Bestmed Medical Scheme's reply19 Aug 2022, 14:23
Official
Dear Brighton,
Kindly be advised that the case was escalated for evaluation and feedback is as follows:
Benefits for elective and planned surgery or procedures abroad shall be subject to pre-authorization, Scheme protocols, and Scheme tariff. The request for procedure was reviewed and we regret to inform you that the service is not funded on your registered benefit option. Funding is based on scheme rules and benefit option funding guidelines and your current benefit option does not cater for this procedure, as such, the scheme is unable to approve the requested service as it is not a registered benefit on this option.
Regards
Katlego Ratau
Kindly be advised that the case was escalated for evaluation and feedback is as follows:
Benefits for elective and planned surgery or procedures abroad shall be subject to pre-authorization, Scheme protocols, and Scheme tariff. The request for procedure was reviewed and we regret to inform you that the service is not funded on your registered benefit option. Funding is based on scheme rules and benefit option funding guidelines and your current benefit option does not cater for this procedure, as such, the scheme is unable to approve the requested service as it is not a registered benefit on this option.
Regards
Katlego Ratau