*** / Query #200922Q8ZZ67

On 14 September 2022, after being referred to by my GP (who I saw multiple times due to neck/arm pains, and being prescribed multiple courses of anti-inflammatory, pain medication, cortisone injections, etc, and eventually sent me for x-rays) to a neurosurgeon for further tests and scans, my neurosurgeon requested for authorisation for surgery from Fedhealth for a neck spine fusion which is extremely necessary as I am in constant daily pain, effecting my daily activities. My GP as well as the neurosurgeon sent through all documentation, reports, as well as motivation letters, codes etc. for the procedure to be done. I was advised that the procedure was not covered through my current medical aid plan, BUT, that the doctor could appeal this decision by contacting / motivating the reason for the urgent surgery. The doctor contacted Fedhealth to give this motivation and was advised that the medical adviser would contact him back, BUT TO NO AVAIL. We have contacted Fedhealth DAILY to follow up on progress, when they would be contacting the surgeon etc., just to explain the whole process to another consultant. No notes are being made on the system about our requests for follow ups, so each time it is like phoning for the first time. We have also been in contact with a few team leaders / managers, who has promised to get back to us, but still not one single person at Fedhealth has been in contact with us. I have had to reschedule my procedure 3 times. I was also advised that we could upgrade our current plan (for approximately R3000 more per month) and then the procedure will be covered by that specific plan. We however were further advised by another consultant that we first need to upgrade and then they will only be able to advise whether the procedure will be covered. I am not in a position to upgrade to only be advised that it might not be covered and then paying so much extra for nothing. I have contacted the medical board and issued a complaint with them to investigate same, I will also go to every other social media platform to share my experience should my matter not be resolved. I am very disappointed with Fedhealth Medical Aid, and looking at other reviews with more or less the same complaints, I would not recommend Fedhealth at all, very poor customer service and definitely not looking after their clients best interests.