CS
Candy S

1 reviews | Active since Oct 2012

29 Oct 2015, 14:14

Fedhealth exclusions for Hospitalization

My daughter was rushed into hospital on the 29/09/2015 and was there until the 07/10/2015. While in hospital they had to do a Ultrasound study of the female pelvis. Fedhealth rejected this claim saying i am not covered on my plan for this ? So much for we cover you while in hospital at the Fedhealth rate, but they are paying NOTHING ? I am not even on the lowest plan and it has just shocked me that they reject this and cant even tell me why ? they just say your plan doesn't cover this, so when in hospital before they want to do anything must you check will it be covered. You should be able to be in hospital knowing that all will be covered isn't that why we pay a high price to be on medical aid ? I've looked through the Maxima Standard brochure & i cant see where they state ultra sounds not covered. I have a similar complaint wit my Sons op earlier this year they the hospital used something in theater which is need when operating in the ankle and they rejected this too but approved the procedure, who has the say whats needed or not, surely the Doctors know best, and he is a Fedhealth network Dr so its not like he is going to overcharge !

0
Replies (1)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply29 Oct 2015, 14:19
Official
Hello CS_28,

Dear Fedhealth family member, thanks so much for bringing this matter to our attention. It's important to us that you feel like a valued member of our family, and as such we will do our best to resolve this issue with you.

Kind Regards
The Fedhealth Online Team