Disappointed and Violated Member

To whom it may concern,

Kindly note this is has been a painstaking last few months with Fedhealth Medical schemes. We have being with them for 9 years and it seems like its just not getting better. Last in November i was diagnosed with a serious liver condition, i needed to do a biopsy and my Doctors are only able to do the procedure from the hospital thats is not on the plan that i have. We then upgrade the plan to Fed2 which was covering is since Jan 2026, however in order to do the procedure Dr Padi team got the co payment "waivered" and i was asked to go in on the 7 November for the said procedure, to this stage no one from the medical or hospital spoke about anything i needed to pay. While at hospital other test was done a MRI and CT scan which we paid a co payment for and eventually got it back when it was sent through PMB.

Late December i started receiving bills amounting to 16k for co payments i knew nothing about... Before i forget i requested a broker now going two months to explain and assist me with the new plan that we have, till this day no one has made contact and i do have reference numbers to this effect. i was in hospital from 7 to 11 November a very traumatic experience i am still recovering from the fact that i almost lost my life. So with the assumption that this was all taken care of the medical aid to my surprise i started getting bills that was very unsettling. My Doctor had sent through motivation for the following Chronic Medication For bills to me reviewed under PMB all this was declined and now we sitting with bills for the time i was in hospital. When i asked why isn't the condition covered the response was its not a condition covered by the plan, knowing i have increased and stretched my budget by R3500. Since November we have paid cash for medication that cost in the region of R2900 monthly. This is not something anyone plans for. So my request is for a Fedhealth representive to call me and explain why my stay at hospital cannot be covered under PMB and why Chronis medication is declined. I sat with the consultant for a whole two hours some days i am tired and this is not something i need to worry about, i dont want my health to be on the fence because i dont have a great medical aid. i am beside myself and truly need answers and all bills covered. Its a long road for my total recovery and the last thing i need to worry about is bills. i have been hitting a brick wall with this and i dont have the energy to fight. i mean why did i upgrade the plan just to go through the same experience has been on the previous plan. i would like to be assisted i am not happy with Fedhealth and honestly wish i could find another medical aid, however my health is important and i need to stay on.

i am not able to pay co payment that i wasn't alerted about, they said did send an email while i was in hospital - who looks at their email when you in hospital the right thing to do was to contact my spouse to notify him, the right steps have not been taken and we are now bearing the brunt of this. Kindly make contact soon.

Regards Somashnie Rajkaran *** Membership number