MH (GENCOM-493112) Complaint - Various - Oxygen / Wheelchair / Hearing Aids

MH (GENCOM-493112) Complaint - Various - Oxygen / Wheelchair / Hearing Aids

The feedback was not clear in the letter received that was send.

You are only referring to the appliance benefit and not the prosthesis benefit in your letter. What is the purpose of each benefit?

Also, the explanation about the shared benefit is not clear either, Scheme Rule B14 which is a shared limit with C7 (Where is this documentation you are referring to?) Please include it in the mail.

Also, the oxygen are paid monthly from the benefit, it is just enough for 12 months, so how do we know if we use it for hearing aids and a wheelchair that it will be approved on x-gratia? we can't use the limit and then the oxygen is not paid for, for the rest of the year as my mom is on oxygen 24/7. Also GEMS takes forever to attend to requests / complaints /ex gratia payments which could result in non-limits available for oxygen when needed.

A wheelchair was indeed purchased through Dischem Home Care that included a nappi code and motivation from the Cardiologist due to COPD and Congestive Heart Failure and returned due to the limit being used for Oxygen. Please refer to the member's claims history and you will find it.

I rep**** 7 days ago, did not receive any feedback. GEMS medical aid takes forever to respond to complaints.

I need a MANAGER to call me and talk to me about this. This letter received is NOT answering my questions.