1 reviews | Active since Apr 2019
MEDSHIELD PATHETIC MEDICAL AID
Medshield is the worst medical aid ever. I am fighting with them for the last couple of days to cover my back operation as it is quite an emergency they refused to pay the operation as they find that there is nothing wrong with my back at all (eventhough my back is broken and the discs are busy moving that will cause me to go paralyzed). I am booked for an emergency operation but still they refused to pay the operation after a big fight they did decide to pay my operation but they refuse to pay the Prosthesis, devices to assist with guidance, alignment or delivery of these devices, bone substitution and bone cement as they find it is not important and is cosmetic. I feel it is no use to pay the medical aid anymore as it is no use to have a medical aid as they will not cover an emergency. They want to take your money every month as you owe them the contribution every month. According to me the medical aid is forcing me not to take the operation at the end of the day because how can you pay for the operation but not the prosthesis like the *****s needed to fix my back. I am going to sue Medshield if I am paralyzed as they will be the reason for me not being able to work etc as they will be the reason for wrecking my future. I need this operation not to go paralyzed as my back is broken and the discs are busy moving. I feel no one should ever use Medshield nor be recomended to be used. I am taking this to the papers with all the prove also going to inform Carteblanche to investigate this matter. They also say if I take this operation I have to pay R30000 in for the prosthesis the same day as admission as they do not cover for the prosthesis. No use for authorisation if they do not pay the most important thing of the operation.
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 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
With reference to your enquiry regarding: 230419QD9ZSY
Please be advised that we have been liaising our Hospital Benefits Management and we can advise as follow . Please note that Medivalue option does not have prosthesis benefits, however, the scheme may review the funding on the PMB condition. It should be noted that ICD 10 code M51.2 for the requested procedure is non PMB , hence, the request has been denied. Furthermore, You mentioned that you sustained an injury, However, none of the coding provided from the Dr is confirming this. We trust you find the above in order. Yours sincerely, Medshield
With reference to your enquiry regarding: 230419QD9ZSY
Please be advised that we have been liaising our Hospital Benefits Management and we can advise as follow . Please note that Medivalue option does not have prosthesis benefits, however, the scheme may review the funding on the PMB condition. It should be noted that ICD 10 code M51.2 for the requested procedure is non PMB , hence, the request has been denied. Furthermore, You mentioned that you sustained an injury, However, none of the coding provided from the Dr is confirming this. We trust you find the above in order. Yours sincerely, Medshield
