Flexicare plus...What are we paying for?

I have both my parents on Flexicare plus. My mum recently fell and hurt her hand. So we took her to a private hospital only to find out that her hand was broken and she needed surgery. Apparently falling is not an accidental event and she was refused admission although we were told by the consultant that it would be covered another consultant told us it would not be covered. Get your consultants, hospitals and GPs on the same page. R400000 trauma cover for what! This isn't the first time this happened. In a previous situation at a network GP we were being patronized by the administrators. A waste of hard earned money.