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lianey L

1 reviews | Active since Aug 2013

09 Apr 2019, 11:35

No one listed on network option

I took out a network option last year around Aug. I am now 5-6 weeks pregnant and the drs listed on the network option does not cover pregnancy at all. And there is also no gynae on the option list. I have tried reasoning with medshield members to at least then let me upgrade my medical aid to a non network option but they refused. What am I supposed to do if there is no GP on my current list that handles pregnancy and if he there are not one gynae listed on the option list. I was told that I need to go to a Dr to refer me to a gynae but there will be co-payments. Why is there co-payment when the medical aid won't list a Gynae to the network list. This is not what I was told before I accepted the medical aid quotation. Really frustrated.

0
Replies (2)
Medshield
Medshield's reply09 Apr 2019, 12:36
Official
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
Medshield's reply10 Apr 2019, 15:33
Official
Good day,

With reference to your enquiry regarding: 090419QBS87L
  As discussed telephonically , please be advised that no referral authorisation required for consulting with gynaecologist related to maternity/pregnancy . In addition to that, please note you can consult with any specialist of your choice as we do not have specialist doctors network . It should be noted that if you consult with non-network GP or any doctor who charges the private rate you will be liable for co-payment . Furthermore ,the network hospital in your area is Nelspruit Mediclinic .Lastly , please be advised that option change is only open during November/December every year.  

We trust you find the above in order. Yours sincerely, Medshield