I joined Profmed in 2011, I specifically asked them if the Rhyzotomy procedures that I needed to have would be covered and they said yes.
I joined with my husband and son and we are on the Pro Active Plus benefit.
I have had 2 Rhyzotomy's since being with Profmed, the first one was covered completely and there were no shortfalls.
I have just recently had my 2nd Rhyzotomy since being with Profmed and this time have been getting emails etc from my Specialist and Anesthetist saying that my medical aid did not cover the full amount for this procedure.
My specialist advised that the shortfall on their account is R5118 and my Anesthetist advised that their shortfall is over R1 200.
When speaking to my Specialist's rooms this morning, they advised that Profmed had covered the first Rhyzotomy at 300% but this time they had only covered me at 200% hence the shortfalls.
This is unacceptable, my contribution payments increased this year yet my cover has reduced.
I specifically joined them because they said they would cover the procedures required for my back.
I am completely unsatisfied with this service as how can you pay a higher contribution but have a lesser cover.
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