Resolution Health Medical Scheme
No warning of change of benefits

In October 2012 I was booked to undergo a knee replacement which was then covered by my Hospital Plan. However as I was unable to obtain all the reports requested by resolution due to a specific specialist being fully booked until 2013 I delayed the op and re-booked for December 2012. However I had to cancel, as firstly I had flu, and secondly was still unable to obtain the required report.
Earlier this year I again phoned for pre-authorisation but was astounded to find that resolution had amended the benefits and a Knee replacement was no longer covered by my existing Hospital Plan.
Resolution knew late last year that they would be amending the benefits and that I had to undergo this operation. However they firstly, failed to advise me that the benefits would be changing in January of this year or secondly of at least offering me the benefit of upgrading to an alternative option whereby this procedure would be covered.

Company: Resolution Health Medical Scheme
Country: South Africa

  <     >