Refused authorisation for admission

I am a #momentumhealth4me member. I opted for the Gold membership as I thought that would ensure I got seen to in the event of an emergency, heart attack or stroke. In 21 April 2023 I found myself in the unfortunate position of having a heart attack. My doctor sent me to hospital with a letter stating my condition. I was taken to Vincent Palotti emergency unit. On arrival, they called for authorisation and the lady on the momentum help line told the admissions clerk at Vincent Palotti to send me to a state hospital as I am on a medical insurance not a medical aid and she puts the phone down. The admissions clerk was angry that this woman just plonked the phone down in her ear. A second admissions clerk calls again and they tell him they don't go on chest pain to give authorisation. He went through a list of medical codes and eventually they accepted and gave an authorisation code. I was stabilised and a battery of tests were done. A cardiologist, Dr Pillay, came to me and confirmed that I had a heart attack and that I needed an angiogram to see what the extent was. I would need to be admitted. My husband was summoned by the hospital staff to request a R100 000 payment in order for me to be admitted. When he told them that the medical insurance covers heart attacks they told him that Momentum said that they do not cover an angiogram. Now I ask you, if 80% of heart attacks have to have an angiogram, why would they not cover an angiogram. That would be the logical next step from a heart attack. I subsequently got transfer to a state hospital because #momentumhealth4me does not cover for an angiogram. I had the angiogram done and they could multiple blocked arteries. I have since been scheduled for a bypass. So now I am fighting with Momentum Insure as some doctors bills were not covered as they say there is no code to indicate I had a heart attack. The policy also has a hospital cash back for which I get paid R1000 for every day I am in hospital. I have submitted this claim a month ago and haven't heard anything from Momentum to date. They said the cash back claim takes 7-14 working days to pay out. I've submitted the necessary documentation more than once as they keep asking for it....but to date I've heard nothing.

People please be careful when signing up for medical insurance. They make it sound so rosy but when it comes to the fact, your life is at stake they are not helpful.