JN
Johandi N

1 reviews | Active since May 2019

15 May 2019, 16:29

Fedhealth refuse to pay for pmb

My mother is on Flexifed 3 and was diagnosed with unstable angina which is a pmb. Treatment for prescribed minimum benefits has to be paid for by the medical scheme according to the law. On 18 February 2019 she had an angiogram and the dr needed to place a stent in her artery where it was narrowed. Fedhealth paid R65.55 of the R13225.28 for the stent and refused to cover the outstanding R13159.73. When I called they said they will send it for review because it is a pmb and it will take 14 days. It has been almost 3 months now and every time I call they just say it's still in for review. Last time I called I asked them to email me the complaints procedure of the medical schemes council and they refused, instead they emailed me the reference number of the call. After tons of calls in almost 3 months the problem is still not sorted out!!

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Replies (2)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply16 May 2019, 08:37
Official
Thank you so much for your review we will be in touch shortly.

Kind Regards
The Fedhealth Online Team

Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply16 May 2019, 12:24
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 
The Fedhealth Online Team