1 reviews | Active since Sept 2012
Essential Med caused mayor delay and embarassment
<p>On the 4th of June 16 I was told by my doctor to go to the hospital as my galbladder was causing me incredible pain. We first went to Unitas, and were told they don't accept Essential Med, and were referred to Midstream Mediclinic. They also didn't accept Essential Med, but as I was in so much pain then, and could hardly walk, my husband said that they needed to admit me as a private patient. Essential Med has issued a quarentee after saying they don't for emergencies. Yet the hospital didn't want to accept it. We are now stuck with enormous bills, and had to pay some of it, and I have submitted this to Essential Med, yet their response is that they pay only in 30 days. The doctors are waiting for their money, but we are getting no feedback. I am highly disappointed. Their response is that they are Medical insurance, and not Medical aid, surely their should not be a difference. They advertise as a 100 % medical insurance, and say they are unlimited. I want Essential Med to pay the accounts that I have submitted, as well pay out the hospital quarantee, and the money to be refunded for the accounts that we have had to pay. I am not impressed.</p>
Thank you for bringing your concerning matter under our attention.
We do understand your frustration regarding the admission and payment that was not made as yet. Authorisation was given for three days for the procedure. However there were complications and no case update was given nor was additional request receive for longer stay. The admission was longer than what was authorized for.
We were not inform at the time of the admission that they will not accept the GOP. We have been in contact with the different providers who treated you in hospital in order to obtain certificates and treatment plans. Once all of this is received then the claim will be submitted for processing. You are correct to state that Essential Med is a Medical Health Insurance and not a Medical Aid. The difference is that Essential Med is govern by the Long Term Insurance act and a Medical Aid is govern by the Medical Board.
Medical Aid will cover admission 100% and Essential Med covers stated benefits for every 24 consecutive hours a member spends in hospital but we will also monitor the length of stay in hospital.
Essential Med strives in the best service delivery towards all our valued clients.
Regards,
Essential Group
Thank you for bringing your concerning matter under our attention.
We do understand your frustration regarding the admission and payment that was not made as yet. Authorisation was given for three days for the procedure. However there were complications and no case update was given nor was additional request receive for longer stay. The admission was longer than what was authorized for.
We were not inform at the time of the admission that they will not accept the GOP. We have been in contact with the different providers who treated you in hospital in order to obtain certificates and treatment plans. Once all of this is received then the claim will be submitted for processing. You are correct to state that Essential Med is a Medical Health Insurance and not a Medical Aid. The difference is that Essential Med is govern by the Long Term Insurance act and a Medical Aid is govern by the Medical Board.
Medical Aid will cover admission 100% and Essential Med covers stated benefits for every 24 consecutive hours a member spends in hospital but we will also monitor the length of stay in hospital.
Essential Med strives in the best service delivery towards all our valued clients.
Regards,
Essential Group
It is nearly 30 days for payment, yet, no payments has been made to the providers, as stated above. The accounts must be paid, and Essential Med has collected money from me, no matter if they are an insurance company. If I have insurance on my car, they don't reimburse the tyres, and not the car. Essential Med, pay those accounts that has been submitted. That is what you advertise, and you should do what you say.
It is nearly 30 days for payment, yet, no payments has been made to the providers, as stated above. The accounts must be paid, and Essential Med has collected money from me, no matter if they are an insurance company. If I have insurance on my car, they don't reimburse the tyres, and not the car. Essential Med, pay those accounts that has been submitted. That is what you advertise, and you should do what you say.