1 reviews | Active since Mar 2025
They change your plan and not inform you - they don't pay claims!
This is the worst medical aid I have ever experience in my entire life. I had called in to enquire about my benefits and to my surprise found that the benefits I was promised before taking out the medical was not covered. I then opted to change my plan to a higher option paying double the instalment of the first plan. I was told the new plan will only be active as from 1 April with the new debit order amount going off end of April as system changes are only allowed for upgrade until end of March 2025. To my horror, I noticed that the claims submitted by my gp was short paid and rejected and mind you after calling in to confirm which codes the gp had to use once submitting. The procedure codes document was even emailed to me by Fedhealth prior to going to the gp. I received a phone call from the gp informing me of a short pay and rejected claim and decided to call Fedhealth where I was advised by the consultant Faith in the claims department that who ever processed my upgrade made a mistake and back dated me to 1 March instead of 1 April. I then asked why would you pay claims if one the "new plan" gp visits aren't covered and also who did they consent with because my arrangement with them was as from 1 April. Our payroll run has already been done so basically they are telling me that I would have short paid R2900 then unbeknown to me cover would be suspended because of a mistake someone made with my upgrade. Enquiries were made for the option change with multiple reference numbers 110325QV8JWV / 110325QV8JY5 / 120325QVBSGW / 120325QVBSJ2. Next minute I receive an email my request has been received and my medical aid plan is changed to a hospital plan, not long thereafter I receive an email stating my medical aid plan has been changed to a flexi savings plan. When I called in today and enquired Faith logged a query as per 200325QVS7SG / 200325QVS98D stating there is nothing she can do as the people who needs to help me is on lunch including the team leader and that she will try to call me back later however a query takes 3-5 working days. I told her that is unfair because by then it will be April and the benefits which were supposed to be due to me in March are now being forfeited and on top of that I will be liable to pay for a premium which I had not budgeted for March nor agreed to. On top of that compromising my relationship with my gp as it seems I used his service, played him a fool my providing him with specific procedure codes as per the document emailed to me however now his claims has been rejected. This is unfair, inhumane treatment from a service provider who should be taking care of your health rather than jeopardizing it by doing shady and doggy business in the background without your consent or approval. Worst of all not informing you of anything and you finding changes being made without your approval of when it should have been made. I am still waiting for a failed promise of returning my call! I am truly and utterly disappointed that they give to customers and doctors. Fedhealth seems like a money making scheme and will trample on your sincerity just for them to gain financially. If they continue to do this many people including myself will terminate with them and what will happen to those employed by Fedhealth. I deserve to be treated fairly as paying R5000 per month is not worth the lies.
