Worst medical aid!! They do not communicate properly!!!!!!!!!!!!!!!!!!!

I have been with Medihelp for years now, I never had a problem. We all need to make sure we pay for a medical aid for in case we need to go to hospital. In December my husband broke his leg while we were on holiday in Durban. He didn't want to see a doctor there as he did not know them and our savings were depleted. So not wanting to pay more medical accounts ourselves (because that is why I pay for medical aid) we decided to wait for the new month and then go and see a doctor.

We got to January and went to see a doctor in Arwyp that we got referred to by our GP. We got pre-authorisation from Medihelp. I probably spoke to them 3 times that day as they kept on asking what happened to my husband (why would I want to lie about something like this). Not once did they not tell me that the doctor we are using is not a PMB doctor. I never really understood this term until now as we never really needed to use our hospital cover for specialists.

They now refuse to pay the doctor as he is not a PMB - why must we pay R460000 if we have medical we pay so much for. They will probably keep on referring to their pre-approval document that says the doctor is not a network provider but I did not read that far as I was worried and overwhelmed by my husband's situation. Not once did they confirm with me over the phone that I understand that he is not a network provider for Medihelp. The lady in the customer care told me that they will not phone me for this but I must read!!!!!!!!!!!!! PATHETIC!!!!!!!!!!

Our medical aid was suspended for 5 days, and they told me that they would review the account for the doctor once my services are active again. They then decided to send me a statement telling me they will not pay over R10 000 worth of claims because the procedure that was done on 03/01/2020 (my medical aid was active in those dates) will not be covered because my medical aid was suspended in February!!!!!! This statement was also sent to me a week after the suspension on my medical aid was lifted, which leads to tell me that they did pick up on the account after the suspension was lifted.

I always thought that I was on the better medical aids but Medihelp has proved me wrong.

They might be the "cheaper" option for full cover medical aid but they actually cost you more money that any other medical aid.

They are quick to suspend your medical aid when you don't pay, but it takes months of fighting for them to pay their part when they need to!!! Even if you are up to date with your payments to Medihelp.