1 reviews | Active since Jan 2023
No maternity benefit
In my view this medical aid deserves less than one star. I had a miscarriage earlier the year and in May this year found out I was pregnant again. Unfortunately my gynecologist is not contracted with LA health, my mistake as when i changed medical aids, i enquired with my doctors office is he is contracted with discovery, which he was. I was under the mistaken believe that la health forms part of discovery just to find out after i fell pregnant the first time that my understanding was incorrect. Anyway, i then registered on the maternity benefit again in May 2024. At 5 weeks pregnant I started spotting and was placed on progesterone, a two week prescription is R820 and because my medical savings were depleted I had to pay out of pocket, all good and well. At 9 weeks I started bleeding heavily and was diagnosed with a subchorionic hematoma. At that stage my gynies consults were partially paid and I had a co payment of R550. Due to my miscarriage earlier the year I was referred for an NIPT test, this was not covered and I had to pay R2300 out of pocket, blood tests were also not paid for and I had to pay pathcare R1300 put of pocket. Then my July and August gynecologist appointments were not paid at all, as according to the medical aid, my maternity benefits has run out. All for them to advise that the medical aid only covers for one pregnancy a year and because this is my second pregnancy the maternity benefit overlapped. Meaning they are now unable to pay further consults with my gynecologist as someone needs to manually approve this. I logged my issue in June and we are now in August. I have my anatomy scan on Wednesday and as you guessed this will also not be covered, another R2300 out of pocket. Then I have another consult with my gynecologist on 29 August and if his previous accounts are not paid, I will have to settle the account which is 3 antenatal consults as well as the R13k co payment for when I give birth. Further I am still on progesterone which costs me R820 every two weeks. I am really just so disappointed in this medical aid, there is no support. The 8 antenatal consults which they are supposed to give me, they have only paid for about 4 and then told me sorry your benefits are depleted. If I had known this medical aid was so poor I would have never changed medical aids. Further i would not recommend this medical aid to anyone that I know. Unfortunately baby is due early January 2025 so at this point I am unable to change to a different medical aid but will do so as soon as I am able to. I feel like I am discriminated against because I had a miscarriage and now I am unable to get all the benefits due to me for this second pregnancy. I am financially drained by this whole process and its starting the drain me emotionally as well as there is just no support from this medical aid. You deserve 0 starts in my book
