Resolution Health Medical Scheme
Non disclosure

I consulted with my dentist on 12/10/2013 and he informed me that I need dentures for 2 of my molars (one on either side of my lower jaw) due to over-eruption of my teeth.. I told him that I would reschedule the app as I wanted to confirm benefits as I was quite sure that my medical aid covered plastic dentures. Joy of all joys... I am told by the consultant that plastic dentures are only in the event of ALL my teeth are missing. I left a message early yesterday morning for their team leader to call me to explain further as the wording on the website and the member benefit brochure is very deceiving. Every exclusion/limitation is spelt out clearly except for the one that I am querying.
'Subject to Scheme Protocols and network providers. 1 set of plastic dentures
(upper and lower) per beneficiary. Benefit for plastic dentures granted only once in a 4-year cycle.'
The team leader has not even bothered to return my call... I am extremely disappointed with the level of service provided, are these non-disclosures allowed? Now what do I do from here???

Company: Resolution Health Medical Scheme
Country: South Africa
City: Head office

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