I am an active member of Essential medical aid but there is a challenge whenever I submit a claims. Below is the list of my experiences:-
1. I am unable to access any of the pharmacy partners (Clicks; Dischem and Medi-rite) whereas whenever I call the service centre they always confirm that I am entitled for pharmacy services.
2. I emailed the claim invoice for X-ray in June however Essential medical has not processed the claim for reimbursement. Today (28 Oct 2013).
3. The doctor in their network refused to attend to me due to number of claims that are pending payment from Essential medical aid; I had to go back home without seeing the doctor or attended however I pay their month contribution toward medical aid monthly.
4. Whenever I consult outside their network doctors where I paid cash in advance and submit receipt; none of the receipt where refunded.
5. I called the service centre and they promised to return my call since they mentioned that their system was offline/slow; I waited the whole day and no one has responded to my queries whereas they took down all my details.
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