Not worth the trouble.

I have never been so disappointed with a medical insurance product.

I am 68 years old and very rarely need to visit a GP. For more than three years I have been paying for the premium package, and in all that time I have only used the benefit once, for an eye test required for my driver’s licence renewal.

Today, when I actually needed to see a GP, I contacted them to ask for a list of pre-approved doctors. I was then told that I have to use a doctor on their GP network. In other words, I cannot simply go to my own GP, who knows my medical history and has been my doctor for around 30 years.

To make matters worse, there is not a single suitable network doctor in a safe and reasonably convenient area close to where I live. I therefore decided that I would rather pay out of my own pocket and see my regular GP.

I then asked how I could claim for medication if I used my own GP. I was told that medication would not be covered if the prescription was not issued by one of their network doctors.

Their response stated:

“You may visit any doctor on our GP Network for GP visits and acute medication. Acute medication is medicine like antibiotics that you need to take for a few days only. Your GP can prescribe medication for you from a list of approved medicines called a formulary… Please note that if the prescription is from a GP that is not on the network list then this medication will not be covered.”

This means that, despite paying monthly for years, I am effectively forced to use a doctor chosen by the insurer if I want both the consultation and medication to be covered.

In my opinion, this is extremely misleading. A medical insurance product should make medical care more accessible, not place unreasonable restrictions on elderly clients when they finally need help.

Had this been clearly explained in plain language upfront, I would have thought very carefully before paying for this product for more than three years.

I am now left feeling that I paid for a benefit that is almost impossible to use in a practical and safe way.

I would like the company to explain clearly:

1. Why long-standing clients cannot use their own GP and still receive reasonable cover. 2. Why medication prescribed by a qualified registered GP is not covered simply because that doctor is not on their network. 3. Why there are no suitable network doctors close to my area. 4. What value I have actually received after paying for the premium package for more than three years.

This has been a deeply frustrating and disappointing experience.