1 reviews | Active since Oct 2022
Disappointed
Good day Essential MED I hope you are doing well. My wife, unfortunately, lost her work due to Covid and we only had one salary to keep the household running. We had to cut on a lot of luxuries and we had medical aid from Discovery that we had to stop. So we decided to look for an alternative Essential Med it sounds wonderful. My main question to the consultant was that at the end of the day when we have a medical emergency I want help and don’t to see afterwords that I get bills of thousand of rand that I have to pay out of my pocket when I get out of the hospital. The consultants explain that I must just make sure I ask for permission and keep them notified. And should I get a bill to email to them that they could pay? This was unfortunately not the case. My wife got sick after hours on a Sunday night and took her straight to Netcare Hospital in Alberton. When I showed my medical card they were hesitant to help us. But eventually, a lady assisted us. We got permission from Essensel Med to go to the casualty room. The doctor assist my wife and said she had to be admitted. At this stage, this is morning hours. Now I had to phone for the second time for permission as the consultant explained now I have to get an estimate quotation for my wife of how many days. The lady by the hospital helped with the quotation and was emailed. Essemed explained that my wife can only stay for 3 days and not 5 days if she stays longer I will have to pay out of my pocket. I had to agree to the terms before they would transfer the money and signed a form that they will not be responsible for any extra costs. Out of desperation, I signed to get my wife admitted. The next hurdle was for Essential Med to transfer the money before the hospital could admit her. This was done only a few hours later while my wife was in pain and doctors harassed us for the money or she had to go to another hospital. Long story short I had to take my wife out of the hospital after three days still sick and in pain, and until today she has had issues with her health. A few weeks past now we started to receive bills from the doctors that were sent to Essemed, unfortunately, it was for me and my wife to pay thousands of rands. We are still struggling to pay it off, and the doctor is handing us over for debt collection. With this happening, we are now unable to keep paying Essesmed their monthly premium and sitting without any medical aid. Essemed did pay the money for the emergency room and to be admitted to the hospital ward. The rest is for your pocket.
Thank you for replying on this concerning matter.
"We received the call for casualty on the 26th of June and R3 000 was issued. We also made the payment upfront to the hospital for the casualty visit."
With the above statement, I do agree.
We then received another call for admission and the hospital received a Gop for 3 days with a benefit of R21 500 according to the policy benefits. The hospital was advised should they need additional days for admission after the 3 days they must just inform us in order to amend the Gop. We requested the hospital banking details to make upfront payment and only received the details after a while and made immediate payment.
With the above statement, I do not agree. The doctor explained that my wife needs 5 days. The consultant explained that my policy will only cover the 3 days afterward I will be liable to pay for the extra days I also had to sign a document that EssentialMED will not cover any additional costs before transferring the money. Why do you request hospital banking details for the second payment when you already have the details when you made the first payment? I think the person responsible for realizing the money was sleeping because it was in the early hours of the 27th of June and the consultant's version was that they are not getting hold of the person.
According to our records all accounts received was paid in full except for the difference of R186.63 you are liable for on Dr. Thatcher’s account. The reason for this outstanding amount is because of the R21 500 benefit that is depleted. I have attached the summary of accounts received and paid on your behalf.
With the above statement, I do not agree. If all accounts are paid why do we have multiple doctors that have emailed us accounts that we are currently paying off every month? That is thousands of rand.The hospital has send me an email that there is a credit for EssentialMED
please contact the hospital regarding this.
We have send an personal email to you requesting additional accounts should there still be any outstanding that we did not received. We did not get any response on our email.
I will forward all the accounts to you from the different doctors that we have received. Hope to resolve this matter in a professional manner.
If you require any additional information from me do not hesitate to contact me.
Thank you for replying on this concerning matter.
"We received the call for casualty on the 26th of June and R3 000 was issued. We also made the payment upfront to the hospital for the casualty visit."
With the above statement, I do agree.
We then received another call for admission and the hospital received a Gop for 3 days with a benefit of R21 500 according to the policy benefits. The hospital was advised should they need additional days for admission after the 3 days they must just inform us in order to amend the Gop. We requested the hospital banking details to make upfront payment and only received the details after a while and made immediate payment.
With the above statement, I do not agree. The doctor explained that my wife needs 5 days. The consultant explained that my policy will only cover the 3 days afterward I will be liable to pay for the extra days I also had to sign a document that EssentialMED will not cover any additional costs before transferring the money. Why do you request hospital banking details for the second payment when you already have the details when you made the first payment? I think the person responsible for realizing the money was sleeping because it was in the early hours of the 27th of June and the consultant's version was that they are not getting hold of the person.
According to our records all accounts received was paid in full except for the difference of R186.63 you are liable for on Dr. Thatcher’s account. The reason for this outstanding amount is because of the R21 500 benefit that is depleted. I have attached the summary of accounts received and paid on your behalf.
With the above statement, I do not agree. If all accounts are paid why do we have multiple doctors that have emailed us accounts that we are currently paying off every month? That is thousands of rand.The hospital has send me an email that there is a credit for EssentialMED
please contact the hospital regarding this.
We have send an personal email to you requesting additional accounts should there still be any outstanding that we did not received. We did not get any response on our email.
I will forward all the accounts to you from the different doctors that we have received. Hope to resolve this matter in a professional manner.
If you require any additional information from me do not hesitate to contact me.