Medihelp not covering operation Costs!!
<p>I'm on Dimension Elite, paying roughly R3400pm!</p> <p> </p> <p>I had to go for a Neck Fusion of 1 vertabra!</p> <p> </p> <p>Before I was admitted in Hospital, I had to pay R6700 upfront for hospitalisation!</p> <p> </p> <p>In addision, Im now receivings bills from the Dr stating Medihelp only paid R10000 out of the R30000 cost, and from the anethetists account of R8800, they only paid R3800!</p> <p> </p> <p>I'm a healthy person, but this excess is rediculous!!</p> <p> </p> <p>Furious client!!</p>
Dear tommie-rautenbach
Thank you for taking the time to bring your concerns to our attention.
Medihelp offers different benefit options that members can choose from, each offering unique benefits and priced and structured accordingly. It remains the member’s decision whether, and which risks he wants to ensure, and to choose a benefit option accordingly.
On the Dimension Elite benefit option a R6 700.00 procedure specific co-payment applies per admission on neck and back fusions.
In terms of the Rules of the Scheme, benefits payable on accounts are limited to 100% of the scheme tariff and the member will be liable for payment of any amount exceeding this tariff. Members are free to negotiate tariffs with doctors prior to service rendering as Medihelp has no control over the fees charged by doctors.
Your complaint has been referred for investigation and you will receive feedback from a Client Care consultant.
Kind regards
Medihelp Customer Care
Dear tommie-rautenbach
Thank you for taking the time to bring your concerns to our attention.
Medihelp offers different benefit options that members can choose from, each offering unique benefits and priced and structured accordingly. It remains the member’s decision whether, and which risks he wants to ensure, and to choose a benefit option accordingly.
On the Dimension Elite benefit option a R6 700.00 procedure specific co-payment applies per admission on neck and back fusions.
In terms of the Rules of the Scheme, benefits payable on accounts are limited to 100% of the scheme tariff and the member will be liable for payment of any amount exceeding this tariff. Members are free to negotiate tariffs with doctors prior to service rendering as Medihelp has no control over the fees charged by doctors.
Your complaint has been referred for investigation and you will receive feedback from a Client Care consultant.
Kind regards
Medihelp Customer Care