1 reviews | Active since Apr 2019
Assitant needed urgently - inhumane treatment by Medihelp
In May 2018 I joined Medihelp Medical Aid. We were on a hospital plan Dimension Prime Network 1 , myself, my husband and my daughter. All current treatments at the time were included and there was a 12 month exclusion for those conditions. Diabetes for myself although I used the meds because I was insulin resistant and I was off the meds for more than a year already, gastro reflux, indigestion, hearburn, bladder infection for my husband. My husband had recurring bladder infections and after a while the urine flow became restricted. When my husband went the GP in June 2017 he prescribed Cardura to assist and improve the flow of urine. There was at that stage no mention of any prostate condition. Towards the end of Sept 2018 the dr referred my husband to a urologist for a check up because of the recurring bladder infections. The urologist found that the bladder was pushing through the bladder wall / casing and wanted to perform a procedure to shrink the prostate in order to relieve the pressure on the bladder and so correct the bladder. Authorization was requested from the medical aid and because it was still within the 12 month probation period they had to investigate previous conditions not disclosed. Medihelp's response was that we failed to disclose my husband's "benign prostatic hyperplasia" condition on our application in April 2018 and included that information our GP showed treatment of the condition since June 2017. I had to write a motivation to explain why we failed to disclose this condition. In my letter I explained the same as the above and I confirmed that we were not aware of any prostate condition at the time of applying for membership otherwise we would have disclosed it on the application form. They then cancelled our membership and we had to apply for a new membership. I then wrote to the Council of Medical Schemes. They responded and gave a reference no. Further communication from the Council included a list of prescription from our GP and a questionnaire that the GP had to complete. I responded to the Council to request the results of the tests that the GP used to make his diagnosis and have been following up on my request but to date I have not had any response. Two weeks ago our consultant wrote to the manager of the department at the Council dealing with my case and still no response. Please can you assist with getting this matter resolved. My husband had to go for an emergency operation 27 March 2019 but it was stopped because of the medical aid issues. I asked the Dr to discharge him and my husband needs to use a catheter until this matter with the medical aid is resolved. I now have to pay the hospital cash approximately R60 000. The is constantly in pain and because he has his own business there is also now a loss of income until such time that he can go for the operation. With the catheter he is unable to pick up heavy equipment or drive or move around alot.
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
Thank you for taking the time to bring your complaint to our attention. The contents have been noted and we are currently investigating the matter.
The complaint will be responded to by one of our consultants.
Kind regards
Medihelp Customer Care
