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Lettitia F

1 reviews | Active since May 2015

09 Feb 2018, 10:07

Non payment of PMB bills

In January I suffered a severe heart attack. Just moving from my previous medical aid, on which I have been since 2001, Bestmed gave me a 3 month waiting period and the only reply I got was that according to law they can. PMB's were covered, but they never informed me that should there be any emergencies I can only make use of certain hospitals, of which most are state hospitals. I was transferred by the emergency drs at the hospital I went to to Unitas as this was the only bed they could find in Pretoria in cardio ICU. I have never suffered from any heart disseases and hardly ever get sick. I still don't understand the waiting period or why they don't want to pay the bills for a PMB. According to the Consumer Protection Act they should have informed me about their restrictions during a waiting period and not only after I was admitted to hospital. They did not even offer to have me transferred to a hospital where they would have paid. Now they're also not paying my prescribed medication, except for the cheapest one on the list. My broker and I have sent several enquiries to them but they still refuse to pay. I did not even receive the treatment I should have in hospital and the cardiologist was forced to discharge me before he was entirely satisfied with my condition. So all the good things I've heard about Bestmed was absolute nonsense. Oh, and very interesting is that a colleague who belonged to a medical aid for only 1 year was accepted without a waiting period, with her chronic conditions. Does not sound like Bestmed's treatment of their customers are consistent...

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Replies (1)
Bestmed Medical Scheme
Bestmed Medical Scheme's reply10 Feb 2018, 08:03
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.

Your well-being, as a valued client of the Scheme, is important to all of us at Bestmed.

Regards

Bestmed Medical Scheme