Complain

Good day

I am member of medshield medical aid contributing R3900 on a monthly basis. My husband who is covered in the medical aid went to a podiatrist in January 2020 for treatment of and again went on the 17th February 2020

Today my husband received a call from her treatment doctor who informed him that the medical aid rejected the claim for the 17th indicating that the medical aid does not cover the treatment but the treatment done in January was accepted by the medical aid. Bear in mind that both treatment are the same.

Now the medical aid informed her that they are rejecting the 1st claim for January after the doctor asking as to why the first aim was accepted.

I then called the medical aid call center where I asked the explanation for the rejection. I was informed that the medical aid does not cover podiatrist treatment as its an exclusion. I then reminded the consultant that as part of the medical brochure I received in January I did not see such a condition that podiatrist treatment are not covered. The consultant then explained that this is part of the information on their website as an annexures and I should go to the website to get such information. My question was that why in am not been informed formally of such information like the medical scheme would do every year when I am been sent the medical benefits brochure.

I really feel that we are been taken for a ride by medshield as when they take our monthly contributions they get it and when we go to doctors they now refuse to pay our medical bills. What pains the most is when the consultant tells me to read information on thier website that they have put as annextures and such Information not sent to us.

I would appreciate if my matter can be attended as a matter of urgency