SN
Simangele N

1 reviews | Active since Mar 2015

16 Mar 2026, 13:05

REFUSAL/DECLINING PAYING CLAIMS FROM DOCTORS FOR SERVICES RENDERED WHILE I WAS HOSPITALISED,

I WAS HOSPITALIZED AT VISTA HOSPITAL FROM 27 APRIL 2024 FOR 29 DAYS. SOME MEDICATION CAUSED A SEVERE ALLERGIC REACTION, REQUIRING A GP AND FULL ALLERGY TESTS, WITH BLOODS SENT TO DR FAROOQ INC. (R4,592.40), WHICH STILL HASN’T BEEN PAID. MY PSYCHIATRIST DISCONTINUED DOPAQUEL, WHICH I HAD BEEN TAKING FOR YEARS AND WHICH MADE ME OBESE CLASS 3. HE RECOMMENDED A DIETICIAN (CONSULTED IN HOSPITAL, CLAIM DECLINED) AND PRESCRIBED OZEMPIC, WHICH I HAD TO PAY CASH BECAUSE YOUR COMPANY REFUSES. I ALSO HAVE A CHRONIC ILLNESS REQUIRING BLOOD TESTS EVERY SIX MONTHS UNDER PMB, YET VERMAAK HASN’T PAID SINCE 2022, CLAIMING “BENEFITS USED OUT.” PMBS ARE LEGALLY COVERED! YOUR HEARTLESS NEGLIGENCE IS CAUSING FINANCIAL AND EMOTIONAL STRESS—RESOLVE THESE CLAIMS IMMEDIATELY

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Replies (2)
SN
Simangele N's update16 Mar 2026, 13:17
Reviewer Update
2nd complaine Auth No: ***4 was told by my doctor that I need a gastroscopy and must pay R2,900 for the procedure. I called Medschield, and the agent gave me gibberish and then dropped the call. I need a valid reason why I must pay this when I pay my medical aid every month. Doesn’t it cover gastroscopy? I cannot afford this, and it feels like my life is at risk because of your failures. I pay for medical aid to get proper care—this is unacceptable and dangerous.
Medshield
Medshield's reply16 Mar 2026, 13:47
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