1 reviews | Active since Oct 2021
Feel so ****med by EssentialMed
When I signed up in 2025 Aug, I was advised that there is a network of doctors that I have to use. I called a GP near to where I live, gave her my policy number essential med details, and she confirmed that she is affiliated with EssentialMED. I thought okay fine, I have a doctor on their network and will make use of it. Months go by and my family and I are still seeing this GP. Then bloods are required, GP gives me the required docs, I go to Lancet and bloods gets done, for both my daughter and I. Weeks later, i received an email from Lancet, Im liable to pay over R5000 for bloods. Naturally, I contact EssentialMED explain everything and then get told, sorry the GP who referred you is not a network doctor so we cannot pay for the bloods. Had it been a network doctor, we would have paid. I tried explaining to them that the doctor confirmed that they are affiliated with you, but EssentialMed says sorry that doc is not on our list. As per EssentialMed, doctors do that just to get the patient. My question is; EM noticed im using this doctor for some time now, nobody bothered to advise that this is not a network doctor. I just get told sorry you have to pay Lancet we cannot assist you there.
Totally upset at the lack of service here. Now we work hard for our monies, then we must pay for other medical things on top of that. Before EssentialMed says, we did advise you that you need to use a network GP, Id like to say that what happens if the GP confirms that they are a network doctor. I must now go through your list of doctors. What a schlep. Honestly need to get a better service provider.
Thank you for bringing your concerns to our attention. We sincerely apologise for the inconvenience experienced.
Upon reviewing your query, we found that the pathology claims were unfortunately declined as they were referred by non-network GPs. As EssentialMED is a network-based Health Insurance product, pathology benefits are only covered when referred by a network GP, in accordance with the policy terms and conditions.
Should you require assistance in locating a network provider, our Client Services team will be happy to assist.
Kind regards,
EssentialMED Team
Thank you for bringing your concerns to our attention. We sincerely apologise for the inconvenience experienced.
Upon reviewing your query, we found that the pathology claims were unfortunately declined as they were referred by non-network GPs. As EssentialMED is a network-based Health Insurance product, pathology benefits are only covered when referred by a network GP, in accordance with the policy terms and conditions.
Should you require assistance in locating a network provider, our Client Services team will be happy to assist.
Kind regards,
EssentialMED Team
