********** SERVICE RECEIVED FROM FEDHEALTH MEDICAL SCHEME

On the 5th of April 2022, I was diagnosed with Multiple Sclerosis. I have been a faithful client to Fedhealth Medical Scheme for the past 5 years. Since then, between myself and my Neurologist, we have submitted 3 different applications forms of prescribed MS medication of which 2 were of the same brand. Fedhealth took 3 months at a time to advise that it was declined (I had to call in every single time). My Neurologist has sent through motivational letters which was probably not even looked at.

9 months later and 4 MORE LESIONS HAVE GROWN ON MY BRAIN DUE TO NO MEDICATION BEING APPROVED OR NO VALID REASON AS TO WHY IT HAS NOT BEEN!! THE COMMUNICATION FROM FEDHEALTH IS REVOLTING. The medication costs R7600 for 30 tablets. I am a single mother and cannot afford it. I pay a ton of money for my daughter and I to have the best medical aid also under the impression it would be covered by the chronic benefit they brag about. I have been pushed from pillar to post since April, spoken to several customer care agents in the chronic department who are equipped to deal with such a sensitive case and have been giving me the cold shoulder for the past 9 months. I have an autoimmune disease called Relapsing Remitting Multiple Sclerosis and had my first relapse 2weeks ago. The cherry on the top was when I called Fedhealth whilst laying in hospital on the 14th of December 2022 to find out what was happening with my medication and why it was taking so long to be approved, a lady in the chronic department advised that my medication has been approved since August which is absolutely untrue as I have been calling Fedhealth for the past 9 months and every time I was advised that the medication was declined. Fedhealth declined the 1st application I submitted in April only to “approve” it in August? REALLY???? When asked why no communication was sent out, she advised “sorry we don’t do that. What a joke Fedhealth is. They clearly do not care about their customers who are going through the most with regards to their health and only care about the money they collect monthly. Absolutely Pathetic. She also advised that I take my script to Dischem and they will assist me. I get to Dischem and absolutely nothing is loaded on the system. Finally, I call them on the 22nd of December 2022 and lose my mind, as they only take you seriously then. I was put through to the EX- GRATIA department where Thabiso Pieterson advised me that the board has to approve my claim, and this has no turnaround time. He also advised me that I just needed to fill out the documentation and attach my motivational letter and all will be in order. Yet again, that is not the case. My Neurologist, who is on leave as it is festive, needs to fill out this form, attach documentation etc. WHAT WILL IT TAKE TO GET THE CORRECT INFORMATION FROM YOU GUYS????????? I have been patient enough. I have called, I have begged, I have pleaded. I have had enough and have finally decided to take this case to the ombudsman as well as the Medical Board of South Africa to report Fedhealth for Negligence as I risk more lesions growing on my brain as the days go by. All you want is my money, but you fail to assist me with my medication. Should this continue and I lose my life, I hope you'll be happy that my little girl who is only 6 years old has to grow up with out her mother!!