GL
Garth L
1 reviews | Active since Aug 2015
01 Mar 2024, 12:58
Don't choose Genesis if you suffer from bad mental health
This one star pertains to Genesis' poor cover for mental health. Please be advised that you will not get adequate cover for a severe and life threatening mental health issue. My 17 yrs old daughter was admitted to Akiso Clinic. She was diagnosed with Bipolar Disorder with Generalized Anxiety Disorder. She recently had a traumatic event that exacerbated her condition, hence being admitted. According to her psychiatrist, her prognosis is poor and she is currently experiencing suicidal ideations. They booked her in for their 21 day programme for intensive treatment and rectification. Genesis however will only cover 5 days. They suggest we go to a government facility. Anyone who has been around a government health mental facility will know that this is no place for a 17 yrs old fragile girl. Isn't that any we have medical aid in the first place?! And I'm on their premium package! Now I'm having to pull my daughter out of a facility where she has started to get the help she needs, and where she feels safe. This is going to set her back so badly, and is indeed life threatening.
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Replies (3)
Genesis Medical Scheme's replyOfficial
01 Mar 2024, 14:48Dear Garth
First and foremost, we are very sorry about your daughter’s health condition. We realise that this is a difficult time for you as a family and we wish you all the very best.
While we are really not unsympathetic or unapproachable towards your daughter's current condition, the fact of the matter is that the mental illness benefit on Genesis is limited to R42,000 per beneficiary per year. Her admission was a voluntary admission to a non-DSP facility and hence the benefit limit as per the Scheme Rules apply. Please will you liaise with the clinic again, as this does not equate to 5 days only. And furthermore, it would seem as if none of the doctors or other service providers have offered to reduce their rate - they want full payment.
Please may we request that you direct any further queries that you may have, to the Scheme directly and in writing. Your daughter is a minor and may not want her confidential information to be elaborated upon on a media platform like this.
Yours sincerely
GENESIS MEDICAL SCHEME
Genesis Medical Scheme's reply01 Mar 2024, 14:48
Official
Dear Garth
First and foremost, we are very sorry about your daughter’s health condition. We realise that this is a difficult time for you as a family and we wish you all the very best.
While we are really not unsympathetic or unapproachable towards your daughter's current condition, the fact of the matter is that the mental illness benefit on Genesis is limited to R42,000 per beneficiary per year. Her admission was a voluntary admission to a non-DSP facility and hence the benefit limit as per the Scheme Rules apply. Please will you liaise with the clinic again, as this does not equate to 5 days only. And furthermore, it would seem as if none of the doctors or other service providers have offered to reduce their rate - they want full payment.
Please may we request that you direct any further queries that you may have, to the Scheme directly and in writing. Your daughter is a minor and may not want her confidential information to be elaborated upon on a media platform like this.
Yours sincerely
GENESIS MEDICAL SCHEME
GL
Garth L's updateReviewer Update
01 Mar 2024, 15:04Firstly, I have approached the ombudsman, and he has suggested I give a call to your principle officer. I've left messages, and have not been contacted back.
Secondly, Please don't lecture me as to what I should put on a public platform or not.
Thirdly, your designated service is a government state hospital. The reason I have a medical aid is to avoid those.
Finally, as to Akeso's needing to adjust their billing, they are absolutely gobsmacked that Genesis has declined my daughters' treatment. They simply have not experienced someone who they admitted on an urgent basis having to be prematurely discharged because a medical aid world not cover the 21 days.
And you know as well as I do that R42000 does not make a dent on reputable private facilities.
It is time that Genesis takes mental health seriously!
Secondly, Please don't lecture me as to what I should put on a public platform or not.
Thirdly, your designated service is a government state hospital. The reason I have a medical aid is to avoid those.
Finally, as to Akeso's needing to adjust their billing, they are absolutely gobsmacked that Genesis has declined my daughters' treatment. They simply have not experienced someone who they admitted on an urgent basis having to be prematurely discharged because a medical aid world not cover the 21 days.
And you know as well as I do that R42000 does not make a dent on reputable private facilities.
It is time that Genesis takes mental health seriously!
GL
Garth L's update01 Mar 2024, 15:04
Reviewer Update
Firstly, I have approached the ombudsman, and he has suggested I give a call to your principle officer. I've left messages, and have not been contacted back.
Secondly, Please don't lecture me as to what I should put on a public platform or not.
Thirdly, your designated service is a government state hospital. The reason I have a medical aid is to avoid those.
Finally, as to Akeso's needing to adjust their billing, they are absolutely gobsmacked that Genesis has declined my daughters' treatment. They simply have not experienced someone who they admitted on an urgent basis having to be prematurely discharged because a medical aid world not cover the 21 days.
And you know as well as I do that R42000 does not make a dent on reputable private facilities.
It is time that Genesis takes mental health seriously!
Secondly, Please don't lecture me as to what I should put on a public platform or not.
Thirdly, your designated service is a government state hospital. The reason I have a medical aid is to avoid those.
Finally, as to Akeso's needing to adjust their billing, they are absolutely gobsmacked that Genesis has declined my daughters' treatment. They simply have not experienced someone who they admitted on an urgent basis having to be prematurely discharged because a medical aid world not cover the 21 days.
And you know as well as I do that R42000 does not make a dent on reputable private facilities.
It is time that Genesis takes mental health seriously!
GL
Garth L's updateReviewer Update
01 Mar 2024, 16:04Just a follow up to me taking the advice of the ombudsman to give the principle officer, Mr. vd Merwe, a call. After making several calls and leaving messages for him to contact me back on an urgent basis, it was finally communicated to me the Mr. vd merwe simply does not take calls from us members who pay his salary. So there's that.
GL
Garth L's update01 Mar 2024, 16:04
Reviewer Update
Just a follow up to me taking the advice of the ombudsman to give the principle officer, Mr. vd Merwe, a call. After making several calls and leaving messages for him to contact me back on an urgent basis, it was finally communicated to me the Mr. vd merwe simply does not take calls from us members who pay his salary. So there's that.