Fed up with Horizon...

After being with Horizon Medical Scheme for about 2 to 3 years now, after initially being quite happy with them, even with having to follow up with them on a few Bills and Claims, after the fact, and after they assisted me so well with one op I had to go for, I find myself wanting to cut up my membership card, and just go without Medical Aid/Scheme cover, and do everything via government Hospitals rather.

I'm now so sick and tired of following up with Horizon and Carecross about bills and claims, and information, especially after I check everything in advance with their customer service, and then still get given the wrong information and the run around.

I cannot wait to leave Horizon at the end of the year, and move over to Discovery, who I'm hoping will be much better.

Horizon has ruined myself and my wife's experience with our second pregnancy, and has given me a new found respect for government Hospitals and Clinics, where unnecessary bills, procedures and authorizations that you aren't told about after trying to confirm, don't apply.

Our payments to Horizon are always on time and up to date, thanks to the company I work for, but it seems you pay to be with a Medical Aid/Scheme, and then are still forced to constantly pay out of your own pocket.

If anyone is interested, please see below for one of the many examples of how Horizon has recently let myself and my wife down:

My response to one of their surveys- Your customer service for horizon and carecross, is pointless and useless, because when you try confirming anything prior to a procedure, appointment, or visit to a medical centre, outside of a normal GP visit, you get given then wrong information, you're told to just go, that things will be covered, and that you don't need any authorizations, then you get there, and you're told, this cannot be submitted, this isn't covered and that you have to pay out of your pocket, when you haven't budgeted for it as you were advised otherwise. Also, why must I, as the client, constantly follow up about bills and claims after the fact, after already having phoned prior to appointments and visits to hospitals, dentists and labs. Your customer service consultants may be polite and appear to be helpful, but I've found out the hard way, on multiple occasions, that they are in actuality, not very well informed or helpful. GP visits are always perfectly fine, and previously, at least once, with a minor op I had, you guys were amazing, outside of this however, lately, I am disgusted with how useless you seem to be as a medical aid/scheme. You've ruined myself and my wife's very first hospital visit, which is for our second pregnancy, and we have opted to go government, as we can't afford to go private, thanks to your lack of service. I'm so glad I only have to stay with you guys until the end of the year. The people I have been dealing with at Horizon, over the last 2 months were all unhelpful in the end. I mean in one of your more recent emails you've sent me about one of my queries you stated "We have pleasure in confirming that your claims have been processed as shown below", but then proceed to explain, how none of the tests were covered? (Remarke codes - 514/752) So was it a pleasure to tell me that you can't assist, very strange?