Medical ****

Item: Medshield
Rating: 1
Author: Saphokazi M

I suffer from chronic asthma and during an annual medical exam at work, abnormalities in my chest x-rays were picked up. I went to a pulmonologist who sent me for a CT Scan and a nasal scan, which Medshield declined to pay for, as they said it was related to my asthma (which I am not covered for). The CT scan picked up that I have active TB, but I don't have any symptoms (blood test and stupum came back negative). The Doctor than recommended that I have a bronchoscopy and lung biopsy, which again Medshield has declined to pay for. Their reasoning is that I'm not covered for anything asthma related. I've submitted my a clinical report stating as to why I needed to have the procedures and how TB and asthma are not related and I'm still to receive any response on the matter. So I continue to drown in medical bills as I pay my monthly premiums. It's bad enough that my asthma medication isn't covered ****il the probationary period ends), it's even worse that I am being denied TB treatment based on this.

Helpful (0)

Replies (3)

Medshield's replyOfficial

22 Feb 2019, 11:10

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's reply22 Feb 2019, 11:10

Official

Saphokazi M's updateReviewer Update

27 Feb 2019, 14:53

Medshield has yet to respond. So when I decided to call them , and I was told that the time I the procedures I was still under the 3 months probationary period. Which is was a blatant by their consultant, when I told her that this was in actual fact not the case. She quickly changed her story up, saying that a GP or specialist needed to provide them with a report stating my medical history for 12 months. So basically that is their excuse for not paying my medical bills, the first one was that they won't treat anything asthma related. Hence they won't pay for CT scans, chest and nasal x-rays. So every month they continue to deduct their premiums, whilst I continue to drown in medical bills.

Saphokazi M's update27 Feb 2019, 14:53

Reviewer Update

Medshield's replyOfficial

12 Mar 2019, 15:23

Good day,

With reference to your enquiry regarding: 311017QG6083

Please be advised that motivation letter has been received from the admitting doctor , authorisation reviewed and approved. The account has been reprocessed and paid as per scheme rules and benefits available.
Please note detailed accounts payment has been sent to your personal email address. Yours sincerely, Medshield

Medshield's reply12 Mar 2019, 15:23

Official