MT
Moipone T

1 reviews | Active since Feb 2023

20 Jul 2023, 07:04

This Medical aid is Pathetic

Once again, Umvuzo's medical insurance is appalling. In January, when I battled to get authorization for an ear condition with my ENT specialist, they only paid a portion of the claim and didn't even cover half of the specialist's fee. Now that the ear is still not healing properly, the specialist needs to schedule me for another appointment, but Umvuzo won't approve it. They asked for the audiologist report that accurately describes my issue and the specialist's motivation letter; they received all the paperwork they needed from the specialist; however, they sent a letter canceling permission for the procedure, claiming they didn't receive any paperwork. I find this medical aid to be absolutely disgusting.

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Replies (2)
Umvuzo Health Medical Scheme
Umvuzo Health Medical Scheme's reply21 Jul 2023, 14:49
Official
Dear Moipone,

Thank you for raising your concerns and frustration we caused you, for that we sincerely apologize.

This matter has been resolved and the authorization granted for clams to be paid within Medica Scheme rates.

Wishing you speedy recovery.

Kind Regards,
Umvuzo Health Client Services.
MT
Moipone T's update12 Feb 2024, 14:27
Reviewer Update
After authorizing the procedure since the end of July 2023, Umvuzo has only paid the hospital and never paid the surgeon, and I am a PMB. I have sent endless messages to this medical aid but still nothing. I have even changed my medical aid starting this year, but who is supposed to pay the amount owed to the surgeon? Hello Peter, could you please assist me with contacting their ombudsman? I'd like to take this matter further.