Useless

2 Months ago my pregnant wife had to be rushed to the ER as we feared she was having a miscarriage. When all was set and done the ER advised us that with Fedhealth we need to submit the claim ourselves and that we had 48h to do so. This I could still understand as with the haste I did not bother to check if Mediclinic Cape gate was an authorized provider. The claim was submitted the next day.

Not a word, email or call since, we now received the bill for this visit again stating the medical aid did not cover it. I contacted Fedhealth and I was told that I had to get pre-authorization when being admitted to the hospital... Now I am not sure how they perceive an emergency situation but I cannot imagine anyone waiting around for authorization before rushing to the ER. I also cannot imagine how a medical aid cannot judge that a claim is from an ER and it should be automatically classified as a hospital admission so pre-authorization would then not be a factor. I was told, however, that I can submit it with a late submission fee of R1000. Fedhealth... can you literally hear yourself when you speak? I am paying for medical aid because I cannot afford to pay for hospital fees, but you also don't pay for hospital fees, so you want ME to PAY again (because my monthly premium seemingly isn't enough)... so that you can then go ahead and pay my claim?

Fedhealth made all these promises of everything they cover and benefits and it all sounded wonderful, yet looking at my statements of basic (GP visits and medication) they have covered around R3000 whereas I am out of pocket at least R10 000, not to mention my monthly fee. Fedhealth is literally useless to me and anyone looking to use their services should be very wary of their small print.

Sadly after this incident, everyone I know using this scheme will now be switching providers. Myself included.