Fedhealth Medical Scheme does not "Treat clients Fairly"

This is the way "Treating Clients Fairly" works for Fedhealth Medical Scheme.

On 29 July 2026 an oncologist Dr. happened to mention I had cancer and would require treatment. The different treatments were explained and all the advantages as well as disadvantages were explained to me. I chose what I thought as appropriate, the Dr rooms would apply to Fedhealth Medical Scheme for authorisation. Was scheduled to have a procedure on 27 August 2026.

19 August 2026 received a letter from Fedhealth Medical Scheme to mention the treatment had been approved and was waiting further review from the Oncology department.

24 August 2026 another mail was received to mention the authorisation was declined due to ICON TPRC not approving the treatment due to international standards I would require a higher treatment than chosen and discussed between the Dr and I.

Dr was requested to resubmit with the higher treatment for authorisation.

02 September 2026 another mail was received to mention the new therapy had not yet been approved. On the same day another mail was received to mention the request for authorisation was still under review and outcome would be communicated and outcome provided.

03 September 2026 an extra mail was received to mention the therapy requested was appropriate, but, only available on a higher plan and not the plan I am currently on and the letter does mention I would have to upgrade.

In calling the call centre and speaking to the person, was informed that I could only do a plan upgrade within 30 days of confirmation of diagnosis. The person also did mention I could write a letter to Fedhealth Medical Scheme and mention that different authorisation departments took in excess of 30 days to eventually mention I was on the wrong plan.

This done - today I receive another mail to say how sorry Fedhealth Medical Scheme is to hear that I have been diagnosed with cancer, and in November 2026 apply to upgrade to the appropriate plan as the 30 days has been exceeded.

Being in the service industry and having the "Treating Clients Fairly" in thought. I have had MRI Scan, Biopsy, Bone Density Scan, CT Scan as well as PET Scan. All had to have authorisations before treatments could be app****.

Did nobody at Fedhealth Medical Scheme actually look at this and think, maybe this member has a problem, contact and check if he is on the correct plan?

When the authorisations for the different therapy and treatments were app**** for by the Dr rooms, why could nobody contact me to mention what I was applying for was not on the plan.

Fedhealth Medical Scheme took in excess of 30 days to confirm I had to upgrade to a higher plan, and now when I wish to upgrade get blamed for not doing the appropriate within the time period after Fedhealth Medical Scheme had sent mail to say therapy was approved and just needed further review by the Oncology Department.

Fedhealth Medical Scheme does not provide the type of service anybody could wish for.

Treating Clients Fairly is not part of Fedhealth Medical Scheme mandate.