1 reviews | Active since Jun 2013
Refusing to pay claim
Medshield medical aid is the worsed that there is in South Africa, they refused to pay for my antenatal benefit stating that I went to my GP and my sickness is related to pregnancy, I went to my GP because I was sick not because I had follow up check up with gynae that there was an infection in my urine they saying it falls under antenatal care so if that is the case and it's related to being pregnant why did I not fo see gynae? As a pregnant lady am I not supposed to be sick? First consultation I went to my GP because I wasn't feeling well and to my surprise due to the fact that pregnancy test came positive then automatically it falls under antenatal benefit, I called their call centre enquiring how to activate maternity benefit on 3 occasions I was advised that I have 6 with gynae and 2 scans, on my first gynae consultation I was advised by medshield to get specialist authorization and that too falls under maternity benefit so when and how will my specialist benefit be active. This medical aid scheme I will never in my life recommend it to anyone because am paying monthly but they telling me about codes that must be used as if I submit my own claims and why do I need to suffer as they are my service provider. I would not have any problems paying cash if I had seen gynae 6 times but normal GP then that's it this is ridiculous seriously.
