RS
Richard S

1 reviews | Active since Feb 2017

01 Feb 2017, 11:32

******ion of legislative loopholes in providing PMB medical coverage

<p>Someone in my family needs to be admitted to hospital for a PMB condition. Due to a technicality in the wording of the benefit options, I have a "day-to-day benefit" section of my medical aid, and not a "savings account". The legislation only specifies that "savings accounts" are protected from use for PMB conditions. The medical aid now claims that they are entitled to utilize the day-to-day funds prior to the registration of the PMB condition for additional funding that will be required to continue treatment. The Council for Medical Schemes has confirmed that Medihelp is acting within their rights to do so, and that they have approved the coverage plans.</p> <p> </p> <p>This will result in the entire depletion, within the next month, of all of my day-to-day funds and will create financial difficulties in the immediate future as I will not be able to attend any GP consultation for the entire rest of the year without paying cash. I feel this completely unacceptable and is an ******ion of a wording technicality and defeats the purpose and spirit of the PMB legislation designed to protect health care users.</p>

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Replies (1)
Medihelp
Medihelp's reply01 Feb 2017, 14:50
Official

Dear richspice1

Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.

The complaint will be responded to by one of our consultants.

Kind regards

Medihelp Customer Care