BESTMED DOES NOT PAY FOR EMERGENCY OPERATIONS

My daughter had an accident at school and needed to three teeth extracted by a maxillo oral facial surgeon (dentists said it would be too traumatic). We ended up in the emergency room at Wilgeheuwel where the MOFS was called into the emergency room and took a look at our four-year-old and said he could arrange with an anesthesiologist to do the procedure in the emergency room as opposed to booking my daughter into hospital. This was ideal because then she would not need to endure further trauma. The doctor was excellent, and apart from my princess being damaged, we were happy that she was ok. We are on a hospital plan and I believe that emergency surgery was covered. But when the claims were submitted the medical aid refused to pay saying they don’t cover cosmetic procedures. I tried to explain this was not cosmetic, but emergency - that’s why the procedure was done in the emergency room. When I tried to phone I was on the line for over an hour where the first consultant didn’t have a functioning microphone. She somehow communicated the call reference number where another call operator would see her notes but then the line dropped. Subsequent emails have also proven a complete waste and I simply cannot get a human being on the line. Their offices are in Pretoria so Joburg customers are always going to be a low priority. If a hospital plan doesn’t cover emergency procedures then what’s the point? It seems we should rather always try to abuse the system by being booked in and incur other unnecessary costs and inconvenience to simply get the medical aid to pay. The service has been SHOCKING