The latest is a long line of atrocious service

My Momentum Health experience was atrocious from the start and sadly what I thought was the exception was actually the norm.

I was moving from a closed medical aid (CAMAF) as I had switched jobs but wanted to retain my multiply status so Momentum Health was my only option (and made me a guaranteed sale for someone). Despite this it took over 2 months and countless promises and no call backs before I managed to join and this only because I refused to get it off the line until someone dealt with me. My cell phone bill as a result was sky high but I refused to be without cover. Momentum has to this day not even acknowledge how shocking this process was and what they plan to do to fix it going forward for others (which I asked them to do, I also asked for some key individuals contact details for me to forward my experience to. None of this has been addressed). As a result of that experience I made a conscious decision to not transfer my pension into a Momentum Preservation Fund (as I was resigning and had to move it).

So this was me begging Momentum to sign me up (in order for me to retain my multiply status). I then realised just how inferior the Momentum Health Products are in comparison to CAMAF (now I never expected it to match a closed scheme in terms of benefits but nor did I expect to be paying so much more for so much less. The difference is astounding.) Nonetheless i signed up. But now I find out that even the little that Momentum Health claims to cover - they don't actually. And when you ask for explanations they just point blank ignore requests for feedback, despite numerous promises to get back to me.

I had some queries around my claim vs. what was portrayed during the sales process and then again during the maternity registration process, and would like some clarity.

The claim was for the scan my wife (who is pregnant with twins) undertook. We were advised that the scan is covered by medical aid both during the sales process and then again when she registered on the maternity programme (where she was also given instruction on what codes to instruct the practioner to code as). This however now does not seem to be the case with a number of exclusions app**** to the scan for which i would like some clarity.

The invoice is quite clear (should one bother to read it) so I have used that as my basis of understanding for what the bill is for, and the momentum claim statement as my basis for understanding why Momentum did not pay something they claim is covered for (when in reality it seems that it is not and should therefore be positioned as such in all marketing material).

The invoice submitted (which was all from one scan and nothing else covered the following:

Consultation Fee R616 - Fee for the time of the Dr who conducted the scan .This was partially paid for. So Momentum pays for the scan but not for the person carrying out the scan? Should I have worked the machine myself? Routine OBS UltraSound R550 - The ultrasound scan Paid for. Doppler R484 - Part of the scan .I understand this is what allows yo to hear the heartbeat Not paid for. So despite this being one machine and one scan, this apparently has to come from savings? Was I supposed to ask the DR to switch off the bit that allows you to hear heart beats? I wasn't exactly given a choice Consumables R100 - Consumables used in the scan Partially paid for. So Momentum pays for the scan but not for consumables required for the scan Multiple Gestation Twins R300 - Twin babies were scanned Not paid for. Having twins precludes you from coverage it appears

All under the ICD-1O codes for the pregnancy scan z36 4, z34 9

None of the above was additional or extra. It was all part of the scan (Was I supposed to ask them to only scan for one of the twins???)

So in short Momentum covers you for 2 scans but only if:

You work the machine yourself. The cost of the Dr's consultation fee will only partially be covered You bring your own consumables You don't listen to the heartbeat. How dare you expect that to be part of the scan You don't have twins. Because scans are for singletons only