Maternity Programme: A dishonest scheme

So +-4 months ago we found out my wife is pregnant. Awesome news! I call Momentum Health and register my wife on the Maternity programme and go through the whole rick-and-roll of when/what everything needs to be done. I write most of the stuff down and so forth. The agent says to me, I have cover for two scans (tariff codes 3615 & 3617) but I can only claim one scan before 24 weeks and the other one after 24 weeks (which doesn't sound right).

A few weeks goes by and around week 8 I call Momentum again as in the following few weeks we will be going to the Sonographer for our second scan (I haven't claim anything at this point, paid everything myself) and as the second scan is the Downs syndrome scan between 12-14 weeks (tariff code 3615) I really would like to claim this scan and this also the correct tariff code. Again another agent says that I can only claim one scan before week 24 and one scan after week 24 week. I tell her, that is weird, cause tariff code 3617 is for the 20 weeks Detail scan so it is impossible to claim then as it is also before 24 weeks.. she says she will get back to me (which never happened). I call my broker and she corresponds with Momentum and I get a letter from one of Momentum's main consultants and they say this isn't true, we can claim these two scans as long as it is for tariff codes 3615 & 3617 (my broker and I went into prior year brochures and there was something like that in there), so one two occasions Momentum's agents didn't even know their own policies.

Anyhow, directly after the Downs Syndrome scan at the Sonographer, we went for another scan at a Fetal Specialist at Panaroma as the Sonographer was worried about a certain spot (fluid build up). All of this was done on a Thursday. The following Monday I send through my two accounts (I already paid for them) and ask that Momentum refund me. I noticed there was a mistake in my claim and I call Momentum in 24 hour's time to cancel the claims. The reference number for the call is ********** 50. The agent says, he can't cancel it, I must send an email (all my email reference numbers ********** 83, ********** 44 & ********** 06 for the cancel of these two account claims). I sent an email and I chatted to one of Momentum's agents on the online platform (3 different mediums of support - call, email and online chat). Needless to say, the claims were never cancelled and Momentum paid a minimum amount back to me from the Maternity Benefit. For two months I have tried to get the correct amount paid to me from the Maternity Benefit for tariff code 3615 (I even paid back the amounts to Momentum on instruction from one of the agents; then it got taken off my debit order in the following month) to no avail. Two and half months down the line (chatted to online support most weeks and sometimes two or three times in a week), Momentum has now instructed the agent to tell me that there is a minimum amount for tariff code 3615 and 3617 which is something like R614.25 and doesn't matter what I do, that will stay the same.... On Momentum's brochure it states the following "Scans  On all options, you have cover for 2 foetal growth/maturity scans  Please ask your doctor to use tariff codes 3615 and 3617 only."

Not one agent has told me they have a limit on their scans and even in Momentum's brochure they don't say it. Momentum has also taken away the option that online chat transcripts can be emailed to the client so I have no record of 15+ online chats regarding the follow up that I had to do cause Momentum doesn't get back to me. I've spent a humongous amount of time on the cancel of these claims and still Momentum just don't care or they just leave the queries there so that the client hopefully forgets about it. How can it take two and half month's time to just say "sorry, there is a limit to the maternity benefit for tariff codes 3615 & 3617". I still have the 20 weeks detailed scan that I need to claim, but Momentum's agent has told me that we need to wait on that as we need to finalize the 12 weeks scan first...

I've said it earlier this year to Momentum and I will say it again, Momentum's support structure has gone from great in the prior years to extremely poor in this year. I don't get answers/replies in 48 hours time if I send an email (only an automatic reply with a reference number), I get additional reference numbers for each time I reply/follow up on an existing query (I had to record my reference numbers on Excel as I couldn't keep up with all the reference numbers) and if an agent replies via online chat or phone, there is no way to record the conversation as Momentum has taken away the email function for the copy of transcripts (as posted previously).

After the Safe Dayz debacle earlier this year, the changes in policies (especially the Health Returns) from last year to this year (which I battled for 5 months before I got a comprehensive reply from Dharmisha Naidoo and of course no reply after that) and other claim queries (more than 2 months waiting period on +-80% of these queries), I'm just fed up. I can't do this every second month, following up 5-6 times for legit queries to be sorted out.

I'm really tempted to move my business elsewhere (have 6 products with Momentum, I even wanted to add another one in November, fate intervened and Momentum changed some of the terms & agreement in the middle of November (10th of the month) after I signed the contract with the broker so now that contract is invalid). The amount of hours I've spent to get any sort of proper feedback from Momentum is just ridiculous, clearly Momentum doesn't care about their customers.