Medihelp only pays half on your medical bills during clamis

Why are you paying for medical aid monthly premiums if they would refuse a claim.

On the 8th of September I had a car accident and got left ankle injury/fracture,I performed ORIF on the 9th and went home for healing…I’ve been attending physio therapy sessions and bought moonbooth from my own pocket yet MEDHELP (MEDSaver plan MH***) refuses to fully cover for the procedure done by orthopaedic specialist Dr Nackier,they only covered half of the amount and now I have to settle over R20 000(bare in mind it not co-payment or anything)to the Doctors room.They say my injury is not PMB complying.I called them and they said the qoutes/codes from the Doctor’s department are not covered by medihelp,how the F*** would clients know qoutes and codes that are covered for claims. On the plan,everything is mentioned to be covered by medical aid insurance

It such s disgusting event for them to behave like this during claims, I believe they are just a bunch of ****ming team just like other insurances

I wish I knew better….if you have the same plan consider yourself not covered at all,it such bull**** behaviour