NM
Nokukhanya M

1 reviews | Active since Mar 2018

28 Mar 2018, 10:21

Bestmed Medical Scheme horrible service

I joined Bestmed Medical Scheme in January 2016, I was the principal member (32 years) and my son a depended (10 years old) and for the year 2016 I made a total of R 21,708 . In 2017 I made a total contribution of R 23,856, In May 2017 my son had to have a dental procedure (to have his teeth cleaned and one tooth taken out) done in hospital because of his condition, he has Autism and when I first took him to the Dentist he literally fought with the Dentist, didn't want to be examined so the only option was to have the procedure done in hospital where he will be given Anesthetic so the Dentist can be able to perform the much needed oral hygiene on him. The Dentist advised me to get a recommendation from my son's Pediatrician to attach it to the authorization request to send to my medical aid for approval. A week later on 12 June 2017 we received a decline letter from my medical aid and when I called the medical aid call center I was told the reason why my request was declined its because of the option I was in which was Beat 2 Network, so I was advised to upgrade to Beat 3 Network, but unfortunately I will have to wait until January 2018 to do the upgrade.

January 2018 I upgraded to Beat 3 Network, which costed me an additional R 1 200 pm because in Beat 2 Network I was paying R 1, 988 pm and in Beat 3 Network I had to pay R 3,190 of which it was necessary for my son's sake. February 2018 I started the process of applying for authorization for in hospital dental procedure and on 22 February 2018 I received another decline letter and again when I called I was told again to do another upgrade but this time I told myself its time to pack and go and look for another medical aid provider, Bestmed is playing with my son's health and I can't accept that. On 01 March 2018 I tendered my resignation from Bestmed Medical Scheme. This is what bothers me the most, during all the time I was with Bestmed Medical Scheme I never requested any in hospital authorization for ether my self or my son, this was the first time I ever done something of that sort, I would get my son's chronic medicine from Frere Hospital (Public Hospital), and I would take my son for reviews to a Pediatrician (Dr. Kim) in Frere Hospital (Public Hospital), I never once used my medical aid for my son's condition needs because Autism does not fall in the category of chronic in Bestmed Medical Scheme's Beat 2/Beat 3. I only used my savings portion for GP's consultations or buying medication from the pharmacy that's all.

For them to decline my first ever in hospital procedure, that was going to amount to R 14, 000, yet the total contributions I made to the medical aid at the time I was with them amounts to R 51, 944 they made a huge profit at my expense. The R 4 000 that I had remaining on my savings I was told it will be paid out to me after 5 months and when they told me that I wanted to throw my toys out of the window because right now I am busy raising the R 14, 000 to have this procedure done for my son before its too late.

I hope this will find a right platform and somehow I get compensated and not let Bestmed Medical Scheme get away with this, I still have the two decline letters, if needs be I will also send them.

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Replies (1)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply28 Mar 2018, 11:04
Official

Dear Member

Thank you for taking the time to bring your complaint to our attention.

Kindly note that Bestmed does have an Escalation process for the handling of complaints.

You are most welcome to submit your complaint to the Scheme via *** for assistance by one of our Escalations Specialists.

Regards

Bestmed Medical Scheme