Stay away if you can
<p>I've been with Essential Med for about 4 year. Their day-to-day benefits do have some good points - specifically if you are exceptionally healthy, but the quality of the doctors on the Care Cross platform are not of the highest quality. Of the 6 times in about 3 years I visited a particular GP it was never the same person, similar to cattle herding I presume, but irrelevant of that it was for the usual ailments and nothing crucial and the service was mediocre yet sufficient, albeit slow and impersonal. I have visited a better GP for which I paid out of pocket - but it was worth the extra cost to go to someone better educated and experienced. Also note Essential Med will not pay or hospitalise you if you are injured whilst performing sports - so stay away from trail running or obstacle races - you’ll probably die.</p> <p> <br />Unfortunately as a women we need to see specialists once a year - which Essential Med does not cover. Luckily the doctor gave me a considerable discount after Essential Med rejected my claim, I then tried to claim again but this fell outside the 90 day period and my claim was rejected. Red tape seems to make them some good money.</p> <p> <br />The dentist are okay - nothing great. They will patch you up, but again - not of high quality. Also no cover for wisdom teeth removal.</p> <p> <br />Fortunately I have never been hospitalised - so I cannot comment on this. All I know is you can only go to a 1Life hospital - in my area there is not a hospital like that - closest one is 50km. Again, you’ll probably die on the way to 1Life or should I say 0Life?</p> <p> <br />All in all if your strapped for cash but want some form of security - yes go for it - I guess its better than nothing.</p> <p> <br />I have cancelled my policy as the total of paying Essential Med, extra costs for medicine and visits to quality doctors and virgin active gym membership makes a medical aid with health benefits, better doctors and nearby hospitals an obvious choice.</p> <p> </p> <p>Also remember as they love to say - we’re a medical insurance and not a medical aid - so no tax benefits.</p>
Thank you for bringing your concerning matter under our attention.
Essential Med moved away from Care Cross effective 1st July 2013 and the members were informed via SMS regarding the changes. Essential Med with conjunction of Essential1Doctor established a new Network of Dr since 1st of July 2013. Essential Med started to administer themselves from the 1st of July 2014 with the same Network of Providers and added more on a weekly basis.
The members also had an opportunity to nominate dr in their area and our Practice Manager would have contacted the nominated practices in order to get them on board. The practices that is part of the Network should phone Essential Med to confirm benefits.
Unfortunately the practices sign a contract with Essential Med in order to assist our members. Should a Client feel that the practice is not up to standard member should inform us in order to make sure that our Practice Manager visit the practice. In the result of a client going to an out of network doctor where they have to pay they can do so as they have the benefit of 3 out of network visits per year member must pay up front and claim back and Essential Med will reimburse the member according to the agreed rate.
Essential Med does cover for sports injuries under the accident benefit, only time we will not cover for sports injuries would be if you do it professionally and get paid for it. Casualties due to an accident you as member needs to pay cash and claim back. Authorisation needs to be obtained. The specialist benefit we do cover but we only cover certain specialists.
When submitting any claim you have 90 days to submit the claim so that Essential Med can reimburse you as the member and any claim after that received after that time will be seen as stale and this information is given to you as client on the Policy guide. Basic dentistry is covered as follows: normal extractions, fillings, cleaning of the teeth and pain control. On the day of the application the sales consultant does explain this information to the client before they can complete the application and if a client does not agree the application cannot be completed without the member understanding what he/she will be covered for.
Kind regards,
Essential Group
Thank you for bringing your concerning matter under our attention.
Essential Med moved away from Care Cross effective 1st July 2013 and the members were informed via SMS regarding the changes. Essential Med with conjunction of Essential1Doctor established a new Network of Dr since 1st of July 2013. Essential Med started to administer themselves from the 1st of July 2014 with the same Network of Providers and added more on a weekly basis.
The members also had an opportunity to nominate dr in their area and our Practice Manager would have contacted the nominated practices in order to get them on board. The practices that is part of the Network should phone Essential Med to confirm benefits.
Unfortunately the practices sign a contract with Essential Med in order to assist our members. Should a Client feel that the practice is not up to standard member should inform us in order to make sure that our Practice Manager visit the practice. In the result of a client going to an out of network doctor where they have to pay they can do so as they have the benefit of 3 out of network visits per year member must pay up front and claim back and Essential Med will reimburse the member according to the agreed rate.
Essential Med does cover for sports injuries under the accident benefit, only time we will not cover for sports injuries would be if you do it professionally and get paid for it. Casualties due to an accident you as member needs to pay cash and claim back. Authorisation needs to be obtained. The specialist benefit we do cover but we only cover certain specialists.
When submitting any claim you have 90 days to submit the claim so that Essential Med can reimburse you as the member and any claim after that received after that time will be seen as stale and this information is given to you as client on the Policy guide. Basic dentistry is covered as follows: normal extractions, fillings, cleaning of the teeth and pain control. On the day of the application the sales consultant does explain this information to the client before they can complete the application and if a client does not agree the application cannot be completed without the member understanding what he/she will be covered for.
Kind regards,
Essential Group