FM
Fikile M

1 reviews | Active since Apr 2012

01 Oct 2019, 08:39

Fedhealth ******* Rejection of Claims

My wife is pregant and have maternity benefits on my Fedhealth plan (Flexi Fed 2 Grid). I have huge problem as I am sitting with a bill of over a R1000.00 as Fedhealth rejected claims from my GP who is on the Fedhealth GP network. According to the plan my wife has to get two free scans, but the claim for the first scan was rejected. Also the second scan done at the gyaenacologist (Dr ZB Dlamini) was not free as it was paid from my medical savings. Yet the plan says two FREE scans. I am ****ed off because Fedhealth does not follow the plan rules when it it comes to claims. I am also supposed to get free unlimited GP consultations at a GP who is on the Fedhealth network yet I am sitting with a bill from my GP. I am also going to approach the SA Council for Medical Aid Schemes, this is utter *******. I need the first scan to be paid as this is part of the plan's maternity benefits and a refund for the second scan as this is a Free maternity benefit. Fedhealth must fulfill thier obligation as I also fulfill my payment obligations to them. I am also so worried as I do not know if my wife's hospital stay will be covered when she gives birth. Someone needs from Fedhealth needs to explain and confirm this for me. My wife is due early Jan 2019.

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Replies (2)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply01 Oct 2019, 11:08
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 reply01 Oct 2019, 14:42
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 
The Fedhealth Online Team