Don’t care attitudes and imaginary benefits

Honestly, I don’t even know what more to do with you guys and the claim processing. I am beginning to think that you advertise all these benefits to make yourselves look like you have a lot to offer and are the best, but when it gets down to claiming, it’s an actual nightmare. I should actually have reached my vitality steps for the year now based off of all the run arounds I get from you and your employees.

Literally have 3 claims now that aren’t processed and I can’t seem to understand why.

The first one, I complained about last week already when I was told that your Kids casualty benefit is all of a sudden non existent and then suddenly it existed again and settled the actual hospital account. But I am still battling to be reimbursed for the GP consult. First your agent told me that the GP consult (in casualty) is not covered. But how can you go to casualty without seeing a doctor? Does that make sense to you? Previously in 2019 this was my fight too and it took you guys weeks to reimburse me. Do you honestly think this is ok?

Secondly, you tell us we must use your covid risk assessment when we have symptoms and then YOUR system tells us to see the GP and if recommended, get a test. Members have access to 2 of these per calendar year. So you paid the GP fee for my husband but then didn’t pay for the covid test? Again, previously this was not an issue but now it is.

Thirdly, my son contracted Mumps. I first had to struggle to find a doctor on your connected care app to refer me to the GP as our MSA is depleted. Eventually I found a GP on your connected care app and the doctor advised that my son would need a physical consult to determine whether it was mumps or an ear infection. She did the referral and sent me the proof thereafter. We went to the GP yesterday and guess what? The claim wasn’t paid, regardless of the referral. I’ve used this twice this year with no issues, so actually what is the issue now?

Issue after issue lately and you guys just don’t GAF. I’ve queried my non payment of the casualty visit for my daughter and there’s no sense of urgency at all. Why am I even paying almost R10k a month when you guys can’t even be there for me and my family when we need you? This is disappointing and frustrating and you guys need to do better.

Please can an actual supervisor or manager call me? I’m tired of having to have issue after issue. Why am I even on medical aid if this is the stuff I have to deal with?