SB
Sone B

1 reviews | Active since Jan 2019

19 May 2020, 15:20

Hospital authorisation

Since 1 April my family and I have been covered by Medshield. When I undertook this policy I was advised of a 3 month general waiting period and I was ok with that. I was assured by Buhle (works at Optivest) the consultant that PMB will be active immediately. Now, last week I start getting a pain in my left abdomen. After 4 days of self medicating I decide to go to the Dr, GP sent me for a sonar, sonar shows great problems and refer me to a Gynecologist. I see the Gynecologists' the next day and as the GP he is very upset at what he sees. Tells me I need to have the problem removed the next Monday (18 May). Medical aid now refuses to give me hospital authorization because now all of a sudden because of my history this now has a waiting period. Also, "they" decided it is not life threating. I have asked for my voice recording when the policy was taken between me and Optivest. I have asked Ilse from Optivest the same question and also who at Medshield she has been dealing with and who the person is that made the decision…..still no feedback from them. Who are "they" to decide what I feel? can I get through my day like a normal person? can I look after my kids that is at home the whole day? can I do housework like I should because I don't have a helper? can I make food and stand for long periods of time? How is it that this is PLANNED surgery and not life threatening?? I went to the Dr with an unknown pain, he saw the problem and need to fix it. So because the Dr didn't immediately rush me to theater it is now planned.. this problem can become septic, burst and then...….then I need to be rushed to theater and spend how many days in hospital, be more sick than I am now. And, it will cost the medical aid much more than it would now. I have since the day of my birth never NOT been on a medical aid. I have never had any exclusions for nothing besides the normal basic conditions which I fully understand.

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