Medihelp prioritises money over health

To date, Medihelp has not attended to my query, even after I called them, they have not responded. They still continue to debit my account because that’s all they care about, money. They refuse to listen to reason or any motivation given to allow the procedure. They do not respond to any emails or even bother asking for the doctor’s motivation to justify why the procedure is required.

I called them, they keep on transferring my call without any one giving me any feedback or attending to my request. I asked for a cancellation form, they still have not provided it. They threaten me with a waiting period of 30 calendar working days. Which means I cannot join another medical aid and get the help that I need.

Imagine you pay more than 20k to a medical aid that is telling you to cover a procedure from your own pocket as if you are doing a cosmetic surgery or fertility procedures like IVF. This procedure is to remove or kill fibroids without having an open surgery.

Medihelp has not responded to my queries via countless emails. I have called the Hospital Auth department and been on hold for over 30min at a time to no avail. Submitted another request *** they have not responded to any of it. Sent motivation, they still do not respond.

Medihelp- W*** - MH*** Dispute

Response:
Dear Mrs Motloutse The scheme declined the request as this procedure by Dr M A Trouw is an exclusion on your benefit option. Medihelp's objective is not to withhold you from receiving medical services or to dispute the necessity of these services. The Scheme takes the information into account during pre-authorisation and applies all funding decisions within the framework of the Rules when reviewing a case for benefits. Please take note that your new application for the hysterectomy on 13 Mat 2024 by Dr A K de Bruin was received and was send for pre-authorisation , feedback regarding this authorisation will be send as soon as possible. For quick and easy access to information on your Medihelp benefits and membership, use our online platforms. Please click here to log in/register on the Member Zone. You can also access Medihelp’s app for smartphones using your Member Zone login details, to get direct and immediate access to Medihelp information as summarised here: Member Zone & member app. Register for HealthPrint to receive even more value and to manage your health and well-being.Log on to the Member Zone, click on “Docs” and then “Forms” and “More about Medihelp” to download informative pamphlets so that you can get the most from your membership. Kind regards

My response to that: Who asked you to submit an authorisation request for a hysterectomy? I am dealing with the issue of losing my womb and coming to terms with it, you submit it as if it’s a casual thing. In the email sent did I ask you to submit the request on my behalf?
I told you to read my response carefully before giving me a generated response.
I am in this position because you declined the fibroid embolism.

They asked me escalate the matter which I did. No difference made there.