NS
Natasha S

1 reviews | Active since Jul 2021

06 Jan 2023, 19:06

Network providers imposed on "non-network" plans

I have been a member of Profmed since 2015 and have always found their service to be exceptional and always had the confidence that when I needed them the most, I would be covered. And I was.

I was loyal to Profmed even though there are more affordable medical plans with better benefits at other providers but I received such great service from Profmed and had confidence that they had my family covered.

Now they have made some changes to their plans, where they have imposed "Network" providers on their plans or you will need to pay a hefty co-payment. I am disappointed by this change. I specifically did not select their "savvy" option as there is not an abundance of hospitals and treatment facilities where I live. Now I am being limited to hospitals whilst still paying the full price for my plan which used to have no limits on providers.

For the first time since joining Profmed, I am now nervous about if and when I will be covered. I'm pregnant and my OBGYN does not operate from a network hospital. My child's pediatrician does not operate from a network hospital. What makes it more frustrating is that they have different providers for different conditions which means, if the situation arises, you will have to spend 10-20minutes researching which hospital or treatment facility you can go to or pay the hefty co-payment. In some instances the nearest facility to where I stay is 100km round trip.

I am disappointed that Profmed has made these changes and it appears to apply to ALL plans. Unfortunately I am no longer confident in my cover at Profmed.

0
Replies (3)
Profmed Medical Scheme
Profmed Medical Scheme's reply09 Jan 2023, 11:48
Official
Dear Natasha, thank you for your feedback. We really appreciate you taking the time to relay your experience of Profmed. We are so sorry to hear how you feel about these changes, and we will escalate your message to our team and have one of our consultants reach out to you and resolve it as soon as possible. 
NS
Natasha S's update16 Jan 2023, 11:04
Reviewer Update
Hi, thank you for your reply. I am not sure when your "team" will contact me to discuss as I haven't heard anything from Profmed.
Profmed Medical Scheme
Profmed Medical Scheme's reply16 Jan 2023, 12:55
Official
Hi Natasha, we apologise for this delay and will escalate this information immediately.