RW
Raymond W

1 reviews | Active since Jan 2018

09 May 2020, 09:55

Affinity Health - useless cover

The only reason why I gave Affinity a 1 rating, is because I did not have the option of giving them a zero. They advertise unlimited doctor visits, but be aware of the fine print. Since 1 January 2020 you have to get pre authorisation for doctor visits. I contacted them this morning for pre authorisation, but I was declined. After I had to pay in thousands and thousands last year for hospital for treatment they did not cover, I will have to pay for doctor visits myself now. I never had so much problems with a medical aid before. This is the best cover ever, if you do not claim. The day you claim, your problems starts. I pay over R3 500 per month for cover, which ad the additional offering of them, and then this. Be aware Affinity is a medical insurance and not a medical aid and therefor you do not get the tax benefit, another negative for Affinity. The amount of money I had to pay on medical cost from my own pocket is ridiculous, taking into account I am suppose to have cover. I will never recommend this cover ever and will spread my experience as much as possible.

Affinity's name in the industry is not good either. I had to pay a deposit last year for a hospital visit as the hospital said Affinity is a bad payer and therefor you have to pay the hospital and hope you get something back from Affinity. And this comment was made by two different hospitals.

At least you get what you pay for, cheap premiums gives you cheap cover.

0
Replies (8)
Affinity Health
Affinity Health's reply09 May 2020, 17:30
Official
Good Day Raymond W

We sincerely apologize for the experience that you have encountered and will ensure that all of your concerns are thoroughly investigated.

Please note that Affinity Health does prioritize our clients' concerns and take the necessary steps to assist with a resolution as it is not our intention to cause any inconvenience or distress to any of our clients.

A Complaints Officer will be in contact with you to assist.

Kind Regards
Affinity Health Management Team 


RW
Raymond W's update09 May 2020, 18:18
Reviewer Update
I explained the situation to the sister and she went on about other things except my pre authorisation. When I asked the question is she going to give me pre authorisation, she said no. I pay my premium every month and then I get denied to go to the doctor, totally unacceptable. I will be lodging a complaint with the ombudsman as well, just waiting for Affinity formal response
Affinity Health
Affinity Health's reply09 May 2020, 20:47
Official
Good Day Raymond W

Please note that an investigation will be conducted and a Complaints Officer will be in contact to provide you with feedback. 

Kind Regards
Affinity Health Management Team 


RW
Raymond W's update10 May 2020, 11:04
Reviewer Update
I started phoning Affinity a week ago for pre authorisation for the doctor visit and I was told phone Monday. There is a doctor visit tomorrow at 10h00. I give Affinity until then to sort this out otherwise I will take this matter further.
Affinity Health
Affinity Health's reply10 May 2020, 13:21
Official
Good Day Raymond W

A Complaints Officer will be in contact with you first thing tomorrow morning to address all your concerns.

Kind Regards
Affinity Health Management Team.
Affinity Health
Affinity Health's reply11 May 2020, 11:28
Official
Good Day Raymond

We can confirm that you were contacted this morning as promised and the relevant assistance was provided by the Complaints Department.

Customer Service is extremely important  to our Organisation and we ensure that members are assisted in terms of TCF regulations.

Kind Regards
Affinity Health Management Team

RW
Raymond W's update16 May 2020, 19:52
Reviewer Update
Affinity is correct that i was contacted. After this, i did receive the authorisation to go to the doctor with advise of seeking an alternative medical cover. Felt so welcome with affinity telling me to look for alternative cover.
Affinity Health
Affinity Health's reply17 May 2020, 09:53
Official
Good Day Raymond

We are pleased to know that you were assisted with the applicable benefit.

We want to ensure that our members have a medical plan that is suitable to their medical needs. It is imperative to our business to provide transparency to ensure that all customers are treated fairly.

Kind Regards
Affinity Health Management Team