UNHAPPY WITH SERVICE AT TOPMED

We pay a huge amount for Medical Aid with the hope that if we needed medical care we would have it, not have the stress of paying medical bills. This is not the first time that we have had a hassle with Topmed. Last year my son fell ill in school and had to be rushed to hospital for admission. When the hospital called for authorisation, the consultant is unable to give authorisation as he advised that the medication prescribed by the doctor is for sinus and there is no need for admission, so now he is a doctor as well.

This is my case which I have been fighting with TOPMED for the past few months. I was admitted to ICU with my pressure being 215 and was treated by a Physician. He did all the necessary tests and found out that I had Gall Stones, and therefore referred that a Surgeon have a look at me in order to determine if i needed surgery. I was attended by the surgeon who advised that he can not perform any surgery until such time my pressure was normal, and advised I visit him in a month. My account from the surgeon will not be settled by TOPMED, reason being I was admitted for a medical reason and not for surgical consultation. The gall stones was only picked up whilst i was admitted, therefore the Surgeon was referred. Topmed further requested a motivational letter from the Surgeon, which was sent to them, and the claim is still being rejected. We do not abuse our medical aid or hospital benefit, but when we need it TOPMED always needs to find a reason not to pay.

It is sad as we feel we have a good medical aid and suggest it to others, but with service like this. Very Unhappy