Umvuzo's YANDISA Fund

I have been on this medical aid since January 2010 and now is the 1st time I really have to complain. They have a fund called YANDISA which appears on my list of benefits available. I phoned them about 6 months ago to enquire what it was and they told me it is for any shortfall on any appliances needed that is not sufficiently covered by normal limits and subject to authorisation. I had a total knee replacement in 2014 and had to pay the shortfall myself as there was no relief fund offered by them at that time. The knee replacement needs to be redone and I have consulted with 2 other orthopedic surgeons who confirm this and have referred me to a surgeon who specialises in this kind of surgery. The cost of the prosthesis is way over R100K and my medical aid only pay R34K. I then decided to apply for assistance through the Yandisa fund (it shows on my list of benefits as 0 used/R50 000 available. The doctor then got a reduced price for the prosthesis so I could have the op. Mind I mention I am now a pensioner and cannot afford to pay the R50K myself.

I received a call from the administer of Yandisa late yesterday afternoon and her words to me were "I am not very optimistic this will be approved She stated it is because I am a high risk patient ie high BP, insulin resistant and asthmatic. Last year I had a total hysterectomy which is also considered major surgery and no questions were asked and nothing mentioned about me being high risk and too dangerous for surgery etc. My health was exactly the same as it is now, in fact I have lost 30kgs since I had that done. I asked her outright if this is not being approved because I am applying for assistance (which as I mentioned before is stated on my list of benefits), her answer to me was "we expect the medical aid to just pay but are not prepared to make any lifestyle changes etc etc and that if they assist me with the cost of the prosthesis another patient might have to go without. I ask myself is it because I am elderly and they don't want to "invest" that in me or is it because i am WHITE, because it's certainly for nothing to do with the status of my current health. They even insisted on a full report from a physician which I had done and they are still questioning the reliability of the Physicians report. I live on strong pain meds that I have now had to get under cover just to be able to have a fairly normal day. My surgery was scheduled for last Friday 17th January , that never happened, now it's again scheduled for this week Friday 24th and she very much doubts if it will happen then or if it will ever be approved. What is the point of advertising this fund and being so biased when approving it, Do they really think I just want the procedure done again for fun or what. Very disappointed to the point of asking the medical aid council's advice