1 reviews | Active since Aug 2019
Custom Plan **** Maternity Benefit cover
I am 5months pregnant and on the Momentum Custom Plan. When I found out I was pregnant in April, I called the Medical Aid to check what all the maternity benefit covers again, I needed a refresher as my 1st child was covered by Discovery. I got the shock that no pathology is covered at all, my gynea is not on their list of gyneas, thank goodness Mediclinic falls under the hospital list so that is fine. I get 12 antenatal visits but would need to register in order for it to be covered. I then told the consultant in April when I registered, okay, I don't feel.comfortable changing gyneas, i cant register for GAP cover because its a pre-existing condition, our calls are recorded so I want to stay with my gynea, I will.pay all cost upfront and submit my claim through to the medical aid. The antenatal visit portion that will be covered must be paid to.me. Should there be a shortfall, then I will claim next year from Sars so.I will keep all my invoices/statements/proof of payments etc. I chose this route not to have any complications with my service.provider. I also made it very clear and with every claim that I have submitted that no money/shortfall must be taken from my Health saver account which is seperate from the maternity benefit as the funds in that account (which is already so little) must be kept for my son for in the event I must take him to the Dr or need medical assistance for.him. All the consultants I spoke to assured me that no funds will be taken from my health saver.as.per my request, clearly stipulated in my claim put through AND THAT WAS .... UP UNTIL TODAY!!!!!! I spoke to a consultant reference *** and she told me the shortfall must come from the health saver.. should I not want this to happen then my service provider would need to use codes covered. I am beyond disgusted because firstly all consultants up until today said it's fine becaue I (the client choose to pay the provider upfront) as you don't cover his rates, I have been told to stipulate it in my claim email NO FUNDS TO BE TAKEN FROM HEALTH SAVER, MONEY MUST ONLY BE PAID FROM MATERNITY BENEFIT and yet I am having a problem. If it was a case of me not paying at all, not registering in time for the benefit then there would've been a problem. This has been the worse experience with a medical aid to date that I have had and I.am not happy with your service at all. Be sure that I will be cancelling after all accounts (after birth ofcourse) has been settled as I cannot see why a simple request like the above cannot be adhere too. I will advise the general public not to sign up with momentum, if you earn alot of money and you can afford a more expensive plan.. then maybe they will cover everything but then still have a loophole for.something else :(
Kind Regards
Debbie
Kind Regards
Debbie
