SL
Sally L
1 reviews | Active since Jan 2017
13 Jan 2021, 09:04
Medshield medical aid: the worst medical aid especially for expectant mothers or people planning to have children
I have had the worst experience using Medshield medical aid particularly with the maternity benefits. They have very ambiguous rules whereby some of my claims were rejected without clear explanation for example, refusing to paying for midwife consultations which are way cheaper than Gynae fees. In addition to that, I obtained authorization prior to giving birth and was assured that the Mid-wife will be paid as part of my hospital stay benefit, but again this claim was rejected. The medical brought me no comfort during my pregnancy and now has heighted my stress after giving birth and not having income. I would never recommend this medical aid to any expectant mother. The pregnancy journey is stress as it is and one really needed a good service provider to walk through the journey with, not one that constantly looks for reason not to pay but never fail to deduct their premiums on a monthly basis.
I am in great distress and not even able to care for my newborn baby :(
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Replies (2)SL
Sally L's updateReviewer Update
13 Jan 2021, 11:25I need this urgently attended to because I am truly losing my mind and the practitioner needs her services to be paid for. I am tired of this waiting process as well.
Firstly like I mentioned all claims for consultation with my midwife were rejected. However, the medical aid authorized for the same midwife to administer my birth. Which again adds to the ambiguity of the whole matter because how can the practitioner be allowed to administer my birth but not be allowed to see me and monitor my progress during pregnancy ? I have been left cash strapped by the medical aid as I've had to pay out of my own pocket while unemployed for services I pay for monthly.
Firstly like I mentioned all claims for consultation with my midwife were rejected. However, the medical aid authorized for the same midwife to administer my birth. Which again adds to the ambiguity of the whole matter because how can the practitioner be allowed to administer my birth but not be allowed to see me and monitor my progress during pregnancy ? I have been left cash strapped by the medical aid as I've had to pay out of my own pocket while unemployed for services I pay for monthly.
SL
Sally L's update13 Jan 2021, 11:25
Reviewer Update
I need this urgently attended to because I am truly losing my mind and the practitioner needs her services to be paid for. I am tired of this waiting process as well.
Firstly like I mentioned all claims for consultation with my midwife were rejected. However, the medical aid authorized for the same midwife to administer my birth. Which again adds to the ambiguity of the whole matter because how can the practitioner be allowed to administer my birth but not be allowed to see me and monitor my progress during pregnancy ? I have been left cash strapped by the medical aid as I've had to pay out of my own pocket while unemployed for services I pay for monthly.
Firstly like I mentioned all claims for consultation with my midwife were rejected. However, the medical aid authorized for the same midwife to administer my birth. Which again adds to the ambiguity of the whole matter because how can the practitioner be allowed to administer my birth but not be allowed to see me and monitor my progress during pregnancy ? I have been left cash strapped by the medical aid as I've had to pay out of my own pocket while unemployed for services I pay for monthly.
SL
Sally L's updateReviewer Update
15 Jan 2021, 16:34I got a very unsatisfactory response from Medshield. I honestly feel I am being bul**** by the scheme and not getting my money's worth. For the service I am getting I am as good as not having any medical aid at all. I cannot fathom how the scheme went from being unclear about what they cover and what they do not cover to them paying pur insults of amounts to the claims in question. The consultants also seem ill trained and have varied mandates because the story changes with each consultant I speak to.
I have saved the scheme so much money( which I didn't have to) with the birth plan I opted for. Giving birth at a birthing clinic alone is far cheaper than in a traditional hospital. I opted to work with a midwife over a gynecologist and lastly worked towards ensuring that I have natural birth over a c-section which another very big saving. But the medical aid reverts back to me after I put up a fight with mediocre rates. I need my midwife consultation fees( antenatal and postnatal) and delivery fee to be paid in full. I was assured particularly with the delivery fee that unless my hospital fees exceed R500 000 then there would be no reason for the medical aid not cover my hospital and midwife fees. But this morning I woke up to feedback saying the medical aid will only pay R3300 from the R7500 charged. This is highly concerning and should this matter not be resolved I will unfortunately have to take it to the Ombudsman whilst I also shop for another medical aid.
I have saved the scheme so much money( which I didn't have to) with the birth plan I opted for. Giving birth at a birthing clinic alone is far cheaper than in a traditional hospital. I opted to work with a midwife over a gynecologist and lastly worked towards ensuring that I have natural birth over a c-section which another very big saving. But the medical aid reverts back to me after I put up a fight with mediocre rates. I need my midwife consultation fees( antenatal and postnatal) and delivery fee to be paid in full. I was assured particularly with the delivery fee that unless my hospital fees exceed R500 000 then there would be no reason for the medical aid not cover my hospital and midwife fees. But this morning I woke up to feedback saying the medical aid will only pay R3300 from the R7500 charged. This is highly concerning and should this matter not be resolved I will unfortunately have to take it to the Ombudsman whilst I also shop for another medical aid.
SL
Sally L's update15 Jan 2021, 16:34
Reviewer Update
I got a very unsatisfactory response from Medshield. I honestly feel I am being bul**** by the scheme and not getting my money's worth. For the service I am getting I am as good as not having any medical aid at all. I cannot fathom how the scheme went from being unclear about what they cover and what they do not cover to them paying pur insults of amounts to the claims in question. The consultants also seem ill trained and have varied mandates because the story changes with each consultant I speak to.
I have saved the scheme so much money( which I didn't have to) with the birth plan I opted for. Giving birth at a birthing clinic alone is far cheaper than in a traditional hospital. I opted to work with a midwife over a gynecologist and lastly worked towards ensuring that I have natural birth over a c-section which another very big saving. But the medical aid reverts back to me after I put up a fight with mediocre rates. I need my midwife consultation fees( antenatal and postnatal) and delivery fee to be paid in full. I was assured particularly with the delivery fee that unless my hospital fees exceed R500 000 then there would be no reason for the medical aid not cover my hospital and midwife fees. But this morning I woke up to feedback saying the medical aid will only pay R3300 from the R7500 charged. This is highly concerning and should this matter not be resolved I will unfortunately have to take it to the Ombudsman whilst I also shop for another medical aid.
I have saved the scheme so much money( which I didn't have to) with the birth plan I opted for. Giving birth at a birthing clinic alone is far cheaper than in a traditional hospital. I opted to work with a midwife over a gynecologist and lastly worked towards ensuring that I have natural birth over a c-section which another very big saving. But the medical aid reverts back to me after I put up a fight with mediocre rates. I need my midwife consultation fees( antenatal and postnatal) and delivery fee to be paid in full. I was assured particularly with the delivery fee that unless my hospital fees exceed R500 000 then there would be no reason for the medical aid not cover my hospital and midwife fees. But this morning I woke up to feedback saying the medical aid will only pay R3300 from the R7500 charged. This is highly concerning and should this matter not be resolved I will unfortunately have to take it to the Ombudsman whilst I also shop for another medical aid.