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nadia L

1 reviews | Active since Jun 2023

27 Jun 2023, 11:34

Medical Aids Useless

I have been with this medical aid for the past 3 years. I am left with more unpaid accounts than accounts that is actually paid. The "customer service" department is so unhelpful its scary, they put you on hold for hours and when they actually answer the phone they are so unhelpful. I have a medical procedure that i need to go for, they pay R3750 for something that cost R17874, this is a in hospital procedure why does this get taken out of prosthetics? They also did not pay for my son's Chiropractor after he had an Rugby injury. This medical aids take your money every month and do not pay for anything when you need it. Any suggestions for a medical aid that actually use your money for what it is intended for?? They are dumping me in dept that is all they are good for. in the past financial year i had to pay R15 780 additional on Dr accounts, pathology account that they just do not pay because everything comes out of the "savings". maybe if the put more of my money in the savings account there will be enough to pay for stuff that is actually needed. Like Maternity benefit that we pay for but will never use why cant they allocate the unpaid bills to that.

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Replies (3)
Key Health Medical Aid
Key Health Medical Aid's reply27 Jun 2023, 11:40
Official
Dear Nadia L

We regret to hear about your negative experience, and we appreciate you bringing this matter to our attention. We will investigate the comment and respond back to you.

Sincerely,

The KeyHealth team

Key Health Medical Aid
Key Health Medical Aid's reply27 Jun 2023, 17:17
Official
Dear Nadia L

Kindly allow us time to investigate your comment.  

The matter has been referred to our Clinical department as soon as they reviewed your comment and provided us with feedback, we will respond back to you.

Sincerely,

The KeyHealth team
Key Health Medical Aid
Key Health Medical Aid's reply29 Jun 2023, 09:12
Official
Dear Nadia L

We can assure you that we operate in accordance with the Medical Schemes Act 131 of 1998 and are regulated by the Council for Medical Schemes. Benefits are app**** on all claims according to the scheme protocols and rules, authorizations, scheme's network providers and the member's benefit option.

Our Clinical department did respond back to you via e-mail. They explained to you what is allowed on your chosen option, for your procedure on prosthesis, they also informed you about the KeyHealth Network specialists. On your chosen option you have a savings benefit and a day-to-day benefit, all out of hospital claims will first pay from your savings benefit and then will we apply the day-to-day benefits.  

For future comments and for a quicker response time, kindly send your compliments and complaints to https://www.keyhealthmedical.co.za/comments

Feel free to contact us if you have any further concerns: ***

Sincerely,

The KeyHealth team