Medihelp Terrible

If anybody is looking to join a medical aid, I would strongly suggest you look elsewhere.

My wife has a chronic condition (PMB condition) which has been authorised with the medical aid and was done since the beginning when I first joined Medihelp in July 2019.

My wife has been getting her medication and seeing her specialist since I joined the medical aid, and has never had to pay a levy nor see a GP to get referred to the specialist each time. Suddenly this year, we keep having to pay a levy each time she goes to the specialist because Medihelp just politely decided to change its rules.

They now require that my wife go to the GP for a referral EACH TIME she needs to go to the specialist. My wife has to see the specialist a number of times annually due to the PMB condition; now we must fork over the cost for a levy or a doctors visit every time she needs to see the specialist. It is beyond ridiculous and goes against what is prescribed by the Medical Schemes Council.

From the Medical Schemes Council Website: PMBs are a feature of the Medical Schemes Act, in terms of which medical schemes have to cover the costs related to the diagnosis, treatment and care of:

any emergency medical condition; a limited set of 271 medical conditions (defined in the Diagnosis Treatment Pairs); and 25 chronic conditions (defined in the Chronic Disease List).

Well Medihelp has decided that I must pay a levy or GP's visit everytime we need to access the specialist which forms part of my wife's ongoing care. So they not covering the costs as they should.

Don't join Medihelp!