HELP: I cannot have my dad treated this way!!!!

<p>Dear Resolution Health.</p> <p> </p> <p>My dad has been a member of your scheme for the duration of his retirement.</p> <p>(Gregory Alfred Norkett: ID 550 ********** 080, membership No: 183 861 11).</p> <p> </p> <p>He is a member of your progressive flex option where he pays approximately R2200 per month (which is not a small amount for a pensioner) and has been “satisfied” with your service for the most part of his membership. My dad always asks me whether I think your scheme is a competitor in the current market as opposed to Discovery Health and your other competitors and I assured him that you are (he makes comments such as “you only really find out how good your medical aid is when you need to claim”). Much deliberation and research went into his scheme of choice and thus he has opted for progressive flex which at the cost he pays, we expect to be a popular option for most.</p> <p> </p> <p>My dad was recently diagnosed with Osteo Arthritis in his knees and his doctor recommended knee replacements which my dad accepted since he can no longer deal with the pain whist walking / sitting – or basically carrying out everything associated with his everyday life.</p> <p> </p> <p>Well, much to his dismay – upon sending the requisite motivation through to your contact centre for authorisation to proceed with the knee replacement, he received no further feedback for a period of TWO WHOLE WEEKS.</p> <p> </p> <p>My dad contacted the contact centre AGAIN and was advised that this procedure is not covered but is actually subject to PMB rules and he should therefore send the motivation through again whereafter it will be reviewed by a selection panel.</p> <p> </p> <p>After 2 days my dad received a call from the contact centre to advise that the authorisation was declined as progressive flex exclude joint replacements.</p> <p> </p> <p>My dad reluctantly accepted this contradiction and started exploring his options. He emailed your contact centre on numerous occasions (Ayanda) and was advised that he should change to the millennium select option. When he asked whether this procedure will definitely be covered under the millennium select option and whether he should change mid-year or at the beginning of the year – basically a bunch of unhelpful, vague and uncertain communication followed. This has been the case since his first email enquiry to your contact centre.</p> <p> </p> <p>Resolution Health – my dad is not trying to enrich himself at your expense. He has an illness which is affecting his quality of life and at 62 years old should be enjoying his retirement without the unnecessary stress associated with the DISGUSTING admin he receives from his medical aim scheme which he contributes 24 000 RAND to every year. (We are well aware of the situation most medical schemes find themselves in in South Africa with most of the current workforce not being able to afford medical cover.)</p> <p> </p> <p>All we would like to know is how does my dad go about getting this procure done, does he need to change his option to a more elite benefit option which is R3500 a month and if so, will or won’t the procedure be covered?? Does my dad need to join your competitors – based on the research we’ve done, this procedure will be covered by MANY of them out there.</p> <p> </p> <p>I trust that you will make the necessary decisions required and I hope that you will treat my dad (YOUR CLIENT) with the respect he so deserves and that your feedback will assist him with the queries I have raised above.</p>