1 reviews | Active since Jun 2023
Dissapointed beyond belief in Medshield
I moved to Medshield at the start of the year. Since there was a gap between being at Bonitas and going to Medshield I was happy with the 3 month waiting period before the benefits kicked in.
On Monday morning my son's knee was swollen. I first took him to the Physio and she said that maybe it is Septic Arthritis because she couldn't find any other reason for the swollen knee. We came home and the swelling continued to grow. As this can be serious bacterial infection I took him to one of our Network Hospitals MIdstream Mediclinic Emergency Care.
There they also confirmed it was a bacterial infection in his knees and made an appointment with the orthopedic Surgeon for emergency surgery the next day because they were afraid of it spreading to other parts and into the bloodstream.
Ok. we booked him into the hospital, I came home and the next morning as per protocol I emailed Medshield for Emergency authorisation. Then I get a call from the hospital that the medical aid was not going to pay for the operation or the hospital cost or anything.
Because....they have to investigate the claim, in their words a non declaration investigation. They said they won't pay anything until their investigation is done and that can take months. I asked them why the investigation. They want to know if it was a prior illness that I didn't declare.
I asked them, how do you declare a bacterial infection. Even the hospital said it is a bacterial infection. My child could have lost so much more. I understand that they have protocols in place and I even understand if my son had to go for a knee surgery that is connected to injuries or something.
But seriously, A bacteria infection in the knee. He even had a grass burn on his knee with an open wound where obviously the bacteria entered. How is that a prior injury that I didn't declare. If he had a bacteria infection prior to the 3 months waiting period his leg would have fallen off.
I have never in my life or will never in my life probably in the future ever go through the day yesterday emotionally I had. To lean on people to help with just some money contributions to help cover the emergency surgery no thanks to Medshield.
I seriously wished I could switch my medical aid again through tears of sadness and stress.
I really had high hopes for Medshield and I understand they are a business and a service. But where was this service when my son's leg was on the line. I wish someone can explain to me how an aggresive bacterial infection is a declarable sickness.
So is this going to be the future forward with Medshield. Every emergency is going to be declined because they have to go and do an investigation.
And the best part of everything is they wouldn't even cover the Emergency Room visit. Not even out of my Day to Day benefits.
Medshield Medical Scheme has acknowledged your complaint and is currently investigating.
Kindly note that your concerns have been prioritised and feedback will be provided urgently. We apologize for the delay.
Yours sincerely,
Medshield
Medshield Medical Scheme has acknowledged your complaint and is currently investigating.
Kindly note that your concerns have been prioritised and feedback will be provided urgently. We apologize for the delay.
Yours sincerely,
Medshield
I has been almost a week now since I have laid this complaint. All I received as you say a detailed response is that this complaint is a duplicate and it is still under review.
You know I spoke to a medical aid broker and they said that this case was not even supposed to go under investigation because it falls under PMB. I went to have a look and you know what I find. Pyogenic Arthiritus is under the list. A list by the council of medical aid schemes.
As i have no way of contacting anyone other than the call centre and they saying that they will have someone phone back, or sending an email and getting the same response back this is the only forum probably where I can call you out on.
I said I was understanding to a certain extent but even I and a few other people could right of the bat see that this was no pre existing condition, and even that it takes a week already for you to investigate this is laughable.
No one has phoned or sent a personalised email just acknowledging something, all you get is preempted responses.
Riaan van der Walt
I has been almost a week now since I have laid this complaint. All I received as you say a detailed response is that this complaint is a duplicate and it is still under review.
You know I spoke to a medical aid broker and they said that this case was not even supposed to go under investigation because it falls under PMB. I went to have a look and you know what I find. Pyogenic Arthiritus is under the list. A list by the council of medical aid schemes.
As i have no way of contacting anyone other than the call centre and they saying that they will have someone phone back, or sending an email and getting the same response back this is the only forum probably where I can call you out on.
I said I was understanding to a certain extent but even I and a few other people could right of the bat see that this was no pre existing condition, and even that it takes a week already for you to investigate this is laughable.
No one has phoned or sent a personalised email just acknowledging something, all you get is preempted responses.
Riaan van der Walt
Now the house doctor sent through those documents on the 14th of April 2026. I sent through the letter of motivation yesterday. This after I asked numerous times what else is outstanding because if Medshield cannot do their job I will do it for them. Now I hear from 1 of the providers that there is still numerous documents still outstanding. After I asked in 1000's of emails what is outstanding.
This i surely stalling tactics because seriously what else can it be. Why am I the only one trying to get these documents and no one else. Why everytime i get the correct documents more documents is outstanding.
I have all these emails where I asked what is outstanding, you even spoke to my house doctor, no you are saying a document from the other doctor in the same freaking offices is outstanding. If you took one minute and did your jobs you would see their address is the same.
How many people has to give you documents to tell you that this was a PMB emergency or is Medshield so desperate not to pay me back my money. I even got listed on PMB for his physio therapy and lo and behold even they could see that it was pyogenic arthiritus.
I am not happy with this company. This has been a month now where I jumped through every hurdle and every time you move the goal post so that you are not held liable.
Now the house doctor sent through those documents on the 14th of April 2026. I sent through the letter of motivation yesterday. This after I asked numerous times what else is outstanding because if Medshield cannot do their job I will do it for them. Now I hear from 1 of the providers that there is still numerous documents still outstanding. After I asked in 1000's of emails what is outstanding.
This i surely stalling tactics because seriously what else can it be. Why am I the only one trying to get these documents and no one else. Why everytime i get the correct documents more documents is outstanding.
I have all these emails where I asked what is outstanding, you even spoke to my house doctor, no you are saying a document from the other doctor in the same freaking offices is outstanding. If you took one minute and did your jobs you would see their address is the same.
How many people has to give you documents to tell you that this was a PMB emergency or is Medshield so desperate not to pay me back my money. I even got listed on PMB for his physio therapy and lo and behold even they could see that it was pyogenic arthiritus.
I am not happy with this company. This has been a month now where I jumped through every hurdle and every time you move the goal post so that you are not held liable.