LS
Loandri S

1 reviews | Active since Jan 2016

09 Jan 2020, 13:38

Maybe moving from Discovery WAS a bad idea. Fedhealth's client service is absolutely horrifying!

Getting absolutely no service or feedback regarding my pregnancy query!bFirst email was sent a week ago, this was just an updated letter sent to them again using the same query number which I'll be posting here as well, since this seems to be the only way to get a response. If i knew this would be the level of service, i would've stayed with Discovery!

Dear Fedhealth,

Kindly consider the following:

Medical Schemes Act 131/1998, Section 29A(3) "A medical scheme may impose upon any person in respect of whom an application is made for membership or admission as a dependant, and who was previously a beneficiary of a medical scheme for a continuous period of more than 24 months, terminating less than 90 days immediately prior to the date of application, a general waiting period of up to three months, except in respect of any treatment or diagnostic procedures covered within the prescribed minimum benefits."

At the time of my application for membership 30/10/2019, I was not aware that I was pregnant, nor did I suspected same, nor could I have known same at the time of application. As per the attached pathology report, pregnancy was only confirmed on 9 December 2019.

Further to the above, as per my Discovery Health membership certificate (see attached), I do have continuous membership exceeding 24 months and I have joined Fedhealth within 90 days, which renders me a continuous member an subject to very limited underwriting as per Section 29A(3).

In addition to the above, pregnancy is a Prescribed Minimum Benefit. In view of my membership history and the provisions of the Act, pregnancy cannot legally be excluded from benefits .

In view of all of the above, your imposition of a waiting period on my pregnancy is completely in contravention of the Act. Please advise if you will remove the waiting period with immediate effect and provide cover for the pregnancy, or if you wish that I escalate the matter to your CEO and BoT, or if I should seek mediation from the CMS and/or external legal advice.

I trust that this matter will be resolved without any further delay and I am awaiting your favourable response.

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Replies (2)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply09 Jan 2020, 13:53
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 reply13 Jan 2020, 08:49
Official
A consultant has been in contact with you and detailed feedback has been provided. 

Kind Regards 
The Fedhealth Online Team