Bad Motorcar Accident (with one dead passenger) Hospital Services seen as Day to Day

<p>My wife and I were in a car accident where our passenger, a friend of us, died. The ambulance took us to the hospital for only light external injuries. We were very lucky and blessed. We were advised by a qualified medical sister on the scene as well as ambulance personnel that test need to be done at hospital to confirm there are no internal injuries.</p> <p> </p> <p>Payment of all hospital expenses, including x-rays and an arm sling for my shoulder injury, requested by the trauma doctor, is refused by the Medical Aid, as I am not covered for “Day to Day” expenses. Sorry, the ambulance was paid for.</p> <p> </p> <p>On enquiry, the Medical Aid was very clear about the fact that we were not admitted to hospital and was in the “Trauma” unit only. The reason for the refusal is that I am not covered for “Day to Day” expenses or no funds left in “Day to Day”.</p> <p> </p> <p>Is the medical aid at wrong or the doctor using the wrong codes for services requested from vendors, including his own …….. or me expecting a once in a lifetime accident NOT to be seen by anybody as “Day to Day”….and rather be thankful that I am alive?</p> <p> </p> <p>The “medical aid” send me a PMB (prescribe minimum benefit) form to send to the Trauma doctor to complete. They have all sorts of difficulties with the codes. In the meantime the vendors, the hospital and x-ray guys are sending me FINAL notices after.</p> <p> </p> <p>My medical aid advisor “sent a complaint to Council of Medical Schemes”.</p> <p> </p> <p>I feel that my medical aid is not there for me in a crisis like this. I would like more help from them. I would also like to see plan documentation where something as critical as this is explicitly excluded from hospital cover and seen as “Day to Day”.</p> <p> </p>