VJ
Vanessa J
1 reviews | Active since Jul 2015
30 Jul 2015, 19:59
Refusal to pay for orthotics
My cerebral palsy , epileptic son needs splints for both feet due to shortening of Achilles' tendons and extreme flat feet. Quote:R9417, they will pay R1200! Have got motivation from pediatric orthopedic surgeon and NDT Physio...... They say Cerebral palsy is NOT a PMB! Splints are not fashion accessories so why won't they pay! Client for 17 years! Disgusted with their service!
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Medihelp's replyOfficial
02 May 2023, 21:58Hello VGjorge,
Medihelp's benefit allocation is at all times made within the framework of the Medical Schemes Act, 1998 (Act No 131 of 1998) (the Act) and the registered Rules of the Scheme.
As non-profit medical scheme Medihelp offers a range of benefit options from which members can choose, ranging from comprehensive Medihelp Plus benefit option to a basic hospital plan on the Dimension Prime 1 benefit option. The member's chosen benefit option determines the benefits that are available for the family as the member elects a certain level of insurance against the financial risks of medical expenses in exchange of monthly subscriptions.
Annexure A of the General Regulations of the Act, provides a schedule of \diagnosis and treatment pairs, which qualify for Prescribed Minimum Benefits (PMB). The ICD-10 code provided for Cerebral palsy in this case
Medihelp's benefit allocation is at all times made within the framework of the Medical Schemes Act, 1998 (Act No 131 of 1998) (the Act) and the registered Rules of the Scheme.
As non-profit medical scheme Medihelp offers a range of benefit options from which members can choose, ranging from comprehensive Medihelp Plus benefit option to a basic hospital plan on the Dimension Prime 1 benefit option. The member's chosen benefit option determines the benefits that are available for the family as the member elects a certain level of insurance against the financial risks of medical expenses in exchange of monthly subscriptions.
Annexure A of the General Regulations of the Act, provides a schedule of \diagnosis and treatment pairs, which qualify for Prescribed Minimum Benefits (PMB). The ICD-10 code provided for Cerebral palsy in this case
Best regards,
Medihelp's reply02 May 2023, 21:58
Official
Hello VGjorge,
Medihelp's benefit allocation is at all times made within the framework of the Medical Schemes Act, 1998 (Act No 131 of 1998) (the Act) and the registered Rules of the Scheme.
As non-profit medical scheme Medihelp offers a range of benefit options from which members can choose, ranging from comprehensive Medihelp Plus benefit option to a basic hospital plan on the Dimension Prime 1 benefit option. The member's chosen benefit option determines the benefits that are available for the family as the member elects a certain level of insurance against the financial risks of medical expenses in exchange of monthly subscriptions.
Annexure A of the General Regulations of the Act, provides a schedule of \diagnosis and treatment pairs, which qualify for Prescribed Minimum Benefits (PMB). The ICD-10 code provided for Cerebral palsy in this case
Medihelp's benefit allocation is at all times made within the framework of the Medical Schemes Act, 1998 (Act No 131 of 1998) (the Act) and the registered Rules of the Scheme.
As non-profit medical scheme Medihelp offers a range of benefit options from which members can choose, ranging from comprehensive Medihelp Plus benefit option to a basic hospital plan on the Dimension Prime 1 benefit option. The member's chosen benefit option determines the benefits that are available for the family as the member elects a certain level of insurance against the financial risks of medical expenses in exchange of monthly subscriptions.
Annexure A of the General Regulations of the Act, provides a schedule of \diagnosis and treatment pairs, which qualify for Prescribed Minimum Benefits (PMB). The ICD-10 code provided for Cerebral palsy in this case
Best regards,