1 reviews | Active since Oct 2012

06 Aug 2019, 10:37

Unfairly Treated

i regret ever leaving my prior medical aid for this horrible scheme, they are a **** and *****, when they want you to join their medical aid everythng seem good until where u need them , then u see true colours, things just come up all of a sudden. i joined the scheme on the 1st of April 2019, and only had one waiting period which was the 3 months except on my PMB(hypetesion) as i have being on medical aid for the past 9 years without a break, so i didnt have any other waiting period on my membership certicate. in july i was admitted to hospitalization due to high Blood and also i was 7 weeks pregnat, which was one of the question i was asked before i could be given an authorisation for the admission,why was i ask about pregnacy while im being admitted for my hypetension i didnt get it!! which i was answred that they wanted to ensure that it was not pre-existing condition.. fine i let it be becuase it was not, and after that i called to ask the procedure to see a specialist as i had 6 consulation for pregnacy, i was told to see my family pratitioner who supposed to refer me to any specialist as they do not have a list of specialist under their network. i was under maternity benefit they said. Now a month later on the 05 August 2019 i recieve anonther memebership confirmation which out of the blue my pregnancy is excluded for the first 9 months according to their scheme rules and regulations. what a shock after i had being to see the specialist twice with thier authousiration of course as i made sure i had call before i did anything and they even paid for those consulations. now im told they will reverse those payment,i will have to refund them!!! what!! my question was where was the exclusion on the 02 july 2019 when i was placed under maternity, they didnt know then about their 9 month exclusion??all those diffrent agent i spoke to they didnt know about this scheme rule of 9 months, why wasnt i told then becuase i would have made a decision that was going to be financially and emotionally viable for me and my unborn child.after the stress and difficulties i have with my pregnacy this what i get, and while i paid my premiums faithfully and i left my previous medical where i was happy with their service to me. after i had recommended my mother to join the scheme this is how im being treated. wow.....is this lawfully?my membership is ***, please fix this mess as it not my fault in anyway. and it is not fair this is no way to treat your cutomers.

0
Replies (2)
Medshield
Medshield's reply06 Aug 2019, 11:07
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

Best regards,

's update14 Aug 2019, 10:46
Reviewer Update
Reply to the email i recieved this morning that an Agent callend me on the 07th August 2019:

You are running away from the real problem an issue here, which relates to the matter happaned on the 02 July 2019, where in my complaint i asked why wasnt i told about the pregnacny inclusion on that day? were all your agent not aware of this inclusion until on the 5th of the August 2019, and thirdly becuase your negligence and incompence who is suppoosed to pay for the pregnacy charged that your telling me now that you are going to reverse becuase of your own incompence. address this issue and stop telling me about the agent who called me on th 07 August explaing the pregnacy exclusion, yes and he did just that, he didnt have the answers i have asked above there and he advice that i should write a complait about it and that he confirms that going forward i cant claim anything related to pregnacy but other medical condistions will be covered. and since my baby will be born next year February, so i will start using my pregnacy benefit January 2020, which i didnt dispute. so none of you are answering my real question, can you answer my questionsMembership No: ***