1 reviews | Active since Sept 2009
************** against the elderly!!
<p>My mother in law who is 74 years old and who is on prime dimension3 and paying close to R5000 a month for medical aid is struggeling very much to walk because of her knee cdition. She was turned down AGAIN today even after a specialist wrote a motivational letter for her to have a knee replacement. We have tried to get this done last year as well and was told they will not pay for it as it is " wear n tear" so what they are saying is that you are not allowed to get old because they wont pay for it!! How does one at the age of 74 avoid wear n tear it is part of getting old!! But we were told today that if she goes onto the higher option and pay R 7686.00 a month then they will pay for the same wear n tear they refuse to pay for now!! So it is all about money for them. What pensioner can afford that type of money. and what do they expect her to do now, give up walking and get herself a wheel chair?? To me it seems that medihelp is discriminating against the elderly by refusing to better her quality of life, minimizing her pain and freedom of movement simply because she did what everyone else is doing...getting old!! But if you have the money then getting old is not a problem and the wear n tear no longer applies. she has also started suffering from depression because of the constant pain she is in. But non of this matter to medihelp because they just after the extra money, If i can give anyone some advice do not go onto medihelp if you are on your way to getting old...because u just become part of " wear n tear "</p>
Dear Lezette
Thank you for taking the time to share your concerns regarding your mother-in-law's knee replacement benefits. To enable me to forward the complaint for investigation and feedback, you are kindly requested to supply the correct membership number in a private message.
Kind regards
A du Plessis
Medihelp Customer Care
Best regards,
Dear Lezette
Thank you for taking the time to share your concerns regarding your mother-in-law's knee replacement benefits. To enable me to forward the complaint for investigation and feedback, you are kindly requested to supply the correct membership number in a private message.
Kind regards
A du Plessis
Medihelp Customer Care
Best regards,
hi there sorry was not aware that i entered the wrong number the correct number is ***
we dont know what else to do as she has been walkin with 2 crutches for the past few months but still battles walking and we are just scared one of these days the knee will give in completely and she is going to have a nasty fall pluss the constant pain is driving her insane.
hi there sorry was not aware that i entered the wrong number the correct number is ***
we dont know what else to do as she has been walkin with 2 crutches for the past few months but still battles walking and we are just scared one of these days the knee will give in completely and she is going to have a nasty fall pluss the constant pain is driving her insane.
Dear Lezette
Thank you for supplying the correct membership number. The complaint will be forwarded for investigation and feedback will be provided as soon as possible.
Kind regards
A du Plessis
Medihelp Customer Care
Best regards,
Dear Lezette
Thank you for supplying the correct membership number. The complaint will be forwarded for investigation and feedback will be provided as soon as possible.
Kind regards
A du Plessis
Medihelp Customer Care
Best regards,
Dear cindystyle
Medihelp bases its funding decisions on available information. In view of the report and motivation letter received on 21 January 2016, your mother in law’s knee replacement was declined since there is no evidence of an acute injury.
Medihelp does not question the value or importance of the services required; however, this event does not meet the criteria to qualify for knee replacement benefits on the member’s chosen benefit option.
Medihelp does not take any decision without considering all the relevant facts and possible consequences. I want to assure you that the scheme is not unsympathetic to the individual needs of members, but cannot act contrary to the stipulations of the rules and the Medical Schemes Act of 1998 and therefore no exceptions can be made. The Medical Schemes Act, 1998 places strict obligations on medical schemes to apply their rules consistently to all beneficiaries in order to promote and maintain effective and fair management as far as the granting of benefits is concerned. The Rules of Medihelp are therefore binding on all members and no exceptions can be made, no matter how deserving a case may be.
Kind regards
Medihelp Customer Care
Best regards,
Dear cindystyle
Medihelp bases its funding decisions on available information. In view of the report and motivation letter received on 21 January 2016, your mother in law’s knee replacement was declined since there is no evidence of an acute injury.
Medihelp does not question the value or importance of the services required; however, this event does not meet the criteria to qualify for knee replacement benefits on the member’s chosen benefit option.
Medihelp does not take any decision without considering all the relevant facts and possible consequences. I want to assure you that the scheme is not unsympathetic to the individual needs of members, but cannot act contrary to the stipulations of the rules and the Medical Schemes Act of 1998 and therefore no exceptions can be made. The Medical Schemes Act, 1998 places strict obligations on medical schemes to apply their rules consistently to all beneficiaries in order to promote and maintain effective and fair management as far as the granting of benefits is concerned. The Rules of Medihelp are therefore binding on all members and no exceptions can be made, no matter how deserving a case may be.
Kind regards
Medihelp Customer Care
Best regards,
The motivation that was handed in in Jan 2016 her knee was already bad. it is now a year later and she went to go see another specialist this year. She can not walk at all un aided any more and uses two crutches full time. you say she does not meet the criteria, can you tell me what the criteria is. what will happen if she takes a tumble because the knee gives in completely?? what do you expect her to do about this situation, just give up on walking all together?? i am sorry but i am taking this futher this is not acceptable.
The motivation that was handed in in Jan 2016 her knee was already bad. it is now a year later and she went to go see another specialist this year. She can not walk at all un aided any more and uses two crutches full time. you say she does not meet the criteria, can you tell me what the criteria is. what will happen if she takes a tumble because the knee gives in completely?? what do you expect her to do about this situation, just give up on walking all together?? i am sorry but i am taking this futher this is not acceptable.