Shocking treatment of an 83 year old customer of 48 years on the Medical Scheme

I am at the end of my tether with my very elderly Dad's medical aid. Dad is 83 years old and suffers from quite severe Parkinsons. He has been with Cape Medical Plan since 1976, which I suspect is longer than most of the employees have been alive! The company was bought out some time in the late 90's but Dad stayed on as a customer. For the last 10 years he was on the top of the range package paying just over R16 000 per month for he and my 88 year old Mom. In January this year, (on their advice) he moved to a hospital plan which costs R6400 per month.

Recently Dad attended a dentist who has said that about 10 of his teeth need to be removed due to rotting and an abscess at the back of his mouth. The dentist took X rays and referred us to a Maxillofacial surgeon at Busamed Hillcrest hospital. We made an appointment and saw the surgeon. He did an assessment and recommended Dad have surgery to remove 4 roots and 5 teeth (of course in theatre- given his age and frailty)

However when I contacted Cape Medical plan they have told me that 1) They do not have Hillcrest Busamed as one of their providers and will not be paying for any surgery or stay or anything done at that hospital 2) They will only pay for the root removal of the teeth, not the additional teeth that need to be removed. The total quote for the surgery came in at R10 000, and they will only cover around half of that. In other words, they expect 83 year old Dad to go and have the other teeth removed in a chair on 5 additional days. 3) Dad no longer drives so we now need to start the entire process again at massive expense and time to consult with a different doctor who works at a hospital of their choice which is at least 20km away from where he lives. It is highly inconvenient for us all to get him there for both the appointments and the surgery. 4) I have called his Gap cover but they have advised that it is very unwise to pay for the hospital upfront ourselves (who will require a deposit of around R120 000), as there is no guarantee that the medical aid or themselves will cover it once the procedure is completed.

I really feel that with him having been of the age he is as well as having been a member for just under 50 years that this is the most shocking treatment of an elderly client.