Haven't paid for anything!

I've been contributing to this medical scheme for several years now, and for the first time I get food poisoning and have go to the hospital. First off, the Hospital can't authorize TopMed online, so ok I pay for the doctor, thinking I'll submit a form later.<br> 1 Month later I get a bill from the pathologist saying the Medical Scheme won't pay.<br> 3 Months later I get a bill from the hospital saying that the medical aid won't pay. So I ended up paying the doctor, pathologist and hospital out of my own pocket, WHAT DO I PAY MEDICAL AID FOR???<br> I understand that there are restrictions on all insurance schemes to prevent people from taking advantage of the system, but there's a fairly broad line between people taking advantage of the system, and the system taking advantage of people, and this system has crossed that line and set up a shop there. I shouldn't need to read the small print on page one hundred and whatever of the policy encyclopedia, if I get a \HOSPITAL"plan"