What to do when medical aids refuse to authorise a procedure

CapeTalk's Kieno Kammies took a call from Janita saying that her medical aid refused to authorise her medical procedure.

She approached her medical aid to cover her breast reduction operation as she's been suffering physical pain.

Kammies spoke to the regulatory body to find out what can be done to assist Janita.

Panesh Prema of the Council of Medical Schemes says the council deals with each case on its merits and is willing to look at this case.

If its for cosmetic purposes then that's different, but if it's for specific medical condition then we can look at it.

Panesh Prema, Head of Benefits Management at the Council of Medical Schemes

Listen below to hear how Council of Medical Schemes can assist:


This article first appeared on CapeTalk : What to do when medical aids refuse to authorise a procedure


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