What don't they understand???

<p>So I pay R2 693.00 for this aid per month. I contacted them numerous times before I decided to try this site. Because I don't know where else to turn to. Again, R2 693.00, only for me. And that is just for the Maxima Standard plan. I had advanced dentistry done and submitted the claims. The claims were not acknowledged but questioned with: "Please provide us with more information regarding the claim in question". What more do they need to know? I also asked that and then was advised to close my Self-Payment Gap of R17.76 before they can pay any claims for day-to-day treatment. Again, this was not day-to-day treatment. The lady who "assisted" me, Bernice, sent me this: "Savings: R0.00. OHEB (out-of-hospital expenses benefit: R0.00. Self-Payment Gap: R17.76, Dentistry-Advanced,Oral,Osseo,Orthodontics: R6740.00." And I have the email to prove it. But would they answer when my advanced dentistry claim will pay out? No. They referred me to their website and my GAP. By the way, on their website, for the plan that I am on, they also advertise the same thing. And on 17 August, while explaining my problem to a certain Claire online, she cut me off. So I will go back to the beginning of my querie which Fedhealth don't seem to understand: what is going to happen about my advanced dentistry claim? I am probably waisting my time here because they will probably reply again with: "Please provide us with more information regarding the claim in question". It's a normal claim, I am sure the aid is used to receiving claims ALL THE TIME. Yet, for some odd reason, they do not seem to understand mine. Well let me explain, I have a gap in my mouth where there isn't a tooth. To fix that, there is a dental technichal involved because the technician has to make me one! Which makes it advanced dentistry. All I want to know is what am I paying for? And I have all the emails to prove that I was asking them time and again the whole time "what about my dentist claim?". If I had saved R2 693.00 this whole year, yes well I assume you can guess where I am going with this question. All I want to know is about my dental claim, which was not a normal checkup. It was to get a tooth, which had to be made by a dental technician. So Fedhealth, if you do not understand it now, I don't think you ever will. I actually think you chose not to understand the claim because I have the emails to prove it. By the way people, this is what Fedhealth advertise on their website about the Maxima Standard:</p> <p>Dentistry (Advanced):<br />Inlays, crowns, bridges,<br />mounted study models,<br />metal base partial<br />dentures, osseo-<br />integrated implants,<br />orthognathic surgery,<br />oral surgery, orthodontic<br />treatment, periodontists,<br />prosthodontists and dental<br />technicians</p> <p>Limit of R6 740 per<br />person per year, up to an<br />overall limit of<br />R20 000 per family per<br />year</p> <p>This is copied right off the Internet. And yet, I cannot seem to get a straight answer out of them. And I also have the emails to prove that. So to sum it up, I sent the two claims to the aid, and here i am, still waiting. Been a member since I think 2010, what a waste.</p>