Incompentency

I have to get a neck surgery according to the MRI scan done and Neuro -Surgeon under whose treatment I am. My medical fund with who I am currently refuses to pay for the operation as the option I am on does not cover my condition and it is not a PMB condition, according to the medical aid. I'm on this fund since 2013. My husband had the same operation 4 or 5 years ago on exactly the same option, exactly the same medical fund: Resolution Progressive Flex. Suddenly, this plan does not cover the operation!! I live on pain****ers (Tramacet) every day of my life, struggle to drive my vehicle to work and cannot sleep at night due to this pain. So, because my case is not PMB, I have to boost my stomach with pills – which has a negative impact on the ulcer I have had for many years. If you do not pay your contribution monthly, your services are suspended, but boy oh boy, when you need your medical aid, their "helping hand" disappears to the sun!! I am considering legal steps for pain and suffering as well as loss of income. I am a bookkeeper of occupation and need my hands to execute my duties.