1 reviews | Active since Sept 2016

13 Oct 2020, 09:15

Trash, ****, Trash

I went to a Dr that referred me to a specialist because we found lumps in my breasts which have started growing close to my armpits as well. The specialist said I have excessive breast tissue which needs to be removed in order for it to stop growing and avoid it turning cancerous. The specialist (who I had to pay cash for the consultation) advised that medical will indeed pay this procedure and I would not need to even be hospitalized as it is a one day surgery. I called Fedhealth for authorization and they asked for a motivation from the specialist. Once they got that, they soon asked for the ultra sound scan, which I had to pay for on my own account(R1100). The lady I spoke to at the time said that's all that will be required. I then did a COVID-19 test (which they also advised me they would not pay for unless it comes out positive) but I needed to do it because the hospital does not have any covid patients so it needed to be done. I went to hospital and spent the whole day there waiting for authorization and went back home with nothing. The procedure was rescheduled to 12 October. I called them the whole week regarding authorization and on Friday the 9th, a lady said "everything is fine, we received all your scans and will be sending you correspondence shortly" . I then had to do another COVID-19 test as the previous one was considered invalid by the hospital( another R850 they won't be paying back). I went to the hospital yesterday and they asked for pictures??? Why wasn't this done during the week when I was busy doing follow ups??? So I spent the whole day at the hospital, spent over R200 in airtime because the consultants don't even call you back, only to be told be that the Dr that needs to assess the pictures is busy?? And then, at 16h00 I get an email saying authorization has been declined and my Dr can appeal the decision by writing another motivational letter, after I had been calling these people a whole and from 9am yesterday, did not go to work because the procedure had to be done so I'm not in pain anymore and spending close to R3000+ on tests and airtime they won't be refunding me??

Fedhealth is a **** sham, I'm so over it, definitely changing to another medical aid scheme next year. I can't be paying so much money every month only to be treated like I'm begging for Sassa money hhayi. They don't even care about the emotional distress and physical pain you are in, what's the point of having medical aid if this is how they will treat you when you need them the most??

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Replies (3)
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply13 Oct 2020, 09:32
Official
Dear Member, thank you so much for your message, we are sorry you’re having such a bad experience, please bear with us while we do some investigating.  One of our consultants will be in touch with you as soon as we have a result. 
Best Wishes
Fedhealth
's update15 Oct 2020, 07:53
Reviewer Update
Still nothing? I was contacted by someone who said they would investigate and I'm still waiting. I can't believe that we have to go through so much just to be assisted by a company I pay monthly without fail. I don't understand why you guys are acting like I just want this procedure to be done just for the fun of it. I am in pain everyday and this whole thing is just putting me in emotional distress. I wonder if that Dr. you guys always says needs to authorize hospitalization and procedures also goes through such. Does the Drs family members and children go through so much just to be healed and pain free?? Do I have to get cancer first before you guys can help me?
Fedhealth Medical Scheme
Fedhealth Medical Scheme's reply27 Oct 2020, 15:05
Official
A consultant has been in contact with you and detailed feedback has been provided.
Best Wishes
Fedhealth