1 reviews | Active since Jan 2014
Could keep up to promises given on qoute
Today, (05/11/2017)I had an emergency of which I needed to go to the emergency casualty rooms at Highveld medi-clinic in Secunda.I have given them the policy no,and was told they do not use Essential med,I then called Ess med,and asked why,as when i got the qoutation,I was told they cover casualties in an emergency room.The consultant told me its not her problem,if the hospital does not take essential med.This makes me really worried,as on my policy it states otherwise.I am really dissappointed,what if this was my kids.on another occasion as well,a network doctor gave me a prescription,and upon arriving at the pharmacy,essential med once again mentions they do not pay for those meds,I sent a request to send me a list of meds that are paid for from the formulary,but no response,so how does myself and the network doctor know whats covered,IS THIS A STRATEGY FROM ESSENTIAL MED NOT TO PAY????I just have major concerns: 1. WILL YOU REALLY KEEP UP TO YOUR PROMISES,ON A REAL EMERGENCY WHEN MY FAMILY REQUIRE HOSPITALISATION? 2. HOW CAN ESSENTIAL MED ASSIST IN CASUALTY EMERGENCY VISITS? 3. HOW CAN A CLIENT KNOW WHAT MEDS ARE COVERED? IF I CANNOT GET ASSISTANCE,I WOULD REALLY CONSIDER USING SOMEONE ELSE AND RECCOMEND PERSON NOT TO USE ESSENTIAL MED,AS TODAY I REALLY FELT AS THOUGH I DID NOT RECIEVE THE SERVICE I AM PAYING FOR. AND ALL OF THE ABOVE,YOU MENTIONED AS PER POLICY WILL BE COVERED
Good day,
Thank you for bringing your concerning matter under our attention.
We can confirm that Elize was in contact with you regarding the complaint.
The following was discussed and confirmed:
In the event of casualties some facilities might not accept the Guarantee of Payment and may request a member to pay cash upfront and claim back. For hospital admissions you or the hospital needs to contact Africa Assist to obtain auth for the admission.
Regarding the medication that is covered, it is available on our website. The providers do have the formulary as well when they have a signed agreement.
Essential Med strives in the best service delivery towards all our valued clients.
Kind regards,
Essential Med
Good day,
Thank you for bringing your concerning matter under our attention.
We can confirm that Elize was in contact with you regarding the complaint.
The following was discussed and confirmed:
In the event of casualties some facilities might not accept the Guarantee of Payment and may request a member to pay cash upfront and claim back. For hospital admissions you or the hospital needs to contact Africa Assist to obtain auth for the admission.
Regarding the medication that is covered, it is available on our website. The providers do have the formulary as well when they have a signed agreement.
Essential Med strives in the best service delivery towards all our valued clients.
Kind regards,
Essential Med
