Medscheme
Complaint Y Kotze 91400011062

Good day

This serves as a complaint against my medical aid underwritten by Medscheme

Our new benefit year starts on 1 July 2013 to 31 June 2014.

I submitted my new option on 10 June 2013. This was not updated by Medscheme.

I had a nervous breakdown and was admitted to Poortview Mental Health Facility on 9 July 2013. One of my colleagues Elma de Kramer sorted out with the medical aid to change my plan to what I opted for which was confirmed by Medscheme on 11 July 2013 via e-mail.

According to my Medical Aid (see attached) Psychiatric Treatment & Psychiotherapy is paid at 100% of tariff up to a maximum of 21 days per beneficiary per benefit year.

This benefit include:

o Accomodation
o Medicine
o Anaesthetics
o Dieticians
o General Practitioners
o Occupational therapists,
o Pathology,
o Psychiatrists
o Psychologists
o Radiologists
o Social Workers

Poortview is not contracted out and they charge medical aid rates.

I was there for the full 21 days for treatment.

When I got back to work I received my Monthly Member Statement and realised they did not take the costs from my PMB (Prescribed Minimum Benefits) but from my day to day benefits.

Company: Medscheme
Country: South Africa
City: Florida Hills

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