Medihelp. Declined Pet CT Scan

We decided to move from Discovery to Medihelp at the start of the year. At the end of February 2023 I was diagnosed with seminoma cancer at the age of 29.

I went in for an operation in the first week of February where the affected part was removed.

From there on I was referred, by my urologist, to their Oncology department to start the treatment process for the cancer that I was diagnosed with.

My doctor, a medical professional and expert in the field, said they should start with a PET scan to determine if the cancer has spread and if it is an “aggressive” form of Seminoma cancer as this can not be detected in a blood test.

We requested authorisation from Medihelp twice now and each time it has been denied.

I am denied, by my medical aid, for cancer treatment.

Medihelp’s medical advisor says that the authorisation request is not within South-Africa’s guidelines when it comes to the route my doctor wants to take.

According to Medihelp, a PET/CT scan is not necessary when one has been diagnosed with seminoma cancer.

Surely a medical professional would follow the necessary guidelines and advise on the best treatment plan for their patients? Why would my doctor take unnecessary steps in a case where time is so crucial.

I would have started with treatment weeks ago but because of Medihelp I am refused treatment that is recommended by a medical professional.

To anyone reading this complaint/review, I urge you to seek the best of the best when it comes to medical aid’s. You are expected to pay every month but when it is time to claim they know better than your doctor.

I am meeting with my broker this week to discuss options as this is unacceptable.