MS
Mirriam S

1 reviews | Active since May 2018

15 May 2018, 18:20

Disgruntled medical aid user

I am writing this complaint being disgusted by the treatment medshield medical aid is giving my family.We are members of the medical aid;currently my husband is having a severe eye infection which his Dr advised on an operation which is scheduled for 17/5/2018.Medshield is currently refusing to give authorisation to the hospital for the operation claiming the medical aid is new.We were on medshield before an due to unforseen cicumstanses it lapsed due to non payment in 2017.We reactivated the membership early this year 2018 and we were given a penalty that the medical aid will be activated as from 1/5/2018 which we accepted and have been paying premiums monthly since february 2018 without using the medical aid.Now it is activated but we cannot get authorisation for my husband"s operation which he desperately needs or he will end up going blind if not worse with the infection he has.My question to the medical aid is what are we paying it if we cannot be assisted for hospitilisation for just one day to have the operation;also if i was in an accident unable to talk for myself will they say medical aid is new they cannot authorise for any member of my family to be assisted in hospital.I am angry with their treatment and need better explanation or can they give back all the premiums paid so I can go pay cash at the hospital for my husband to get the treatment he needs and deserve.My medical aid number with the scheme is: ********** 0928

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Replies (2)
Medshield
Medshield's reply16 May 2018, 07:10
Official

Good day,

Medshield Medical Scheme has acknowledged your complaint and is currently investigating.

Kindly note that your concerns have been prioritised and feedback will be provided within 5 working days.

Yours sincerely,

Medshield

Medshield
Medshield's reply23 May 2018, 14:10
Official

Good day

With reference to your Hello Peter Complaint received on the 15/05/2018.

Medshield Medical Scheme has acknowledged your complaint and would like to thank you for bringing your concerns to our attention.

It can be confirmed, an agent from our membership department has been in contact with yourself advising of the denied requested authorisation.

It can be confirmed, a 12 month condition specific waiting period has been imposed on the member with effect from 01/02/2018 to 31/01/2019 due to his eye infection condition not disclosed on the membership application form completed 20/12/2017.

A letter advising of exclusions been app**** and membership certificate has been sent to member.

We trust you find the above in order.