FedHealth.co.za / Fedhealth Medical Aid
Reviews and Complaints

Dear Sirs,
Membership: [protected] - COLLEEN Merle Smart
I resigned from Fedhealth Medical Aid on 2nd July 2018 as 1st was in a Monday.
They have responded accepting my resignation, however stating that an additional premium is due at end of July as my payments are in arrear and not in advance.
I find this extremely unusual as most Medixal AIDS would be in advance for cover for the month surely?
I joined Fedhealth on 1st January 2008.
I have found comparative cover for much less than what I am paying them,
Is there not a Joining date which would be 1 month prior to starting date?
They say according to their records, I am a month behind based on the joining date.
Furthermore, I am told that 50% of the savings I have claimed to date will be owing to them as well.
As I am not yet in Threshold any claims between made between July won't be covered, and yet I paid for July. And I have to pay an additional R7500 for August and those are not covered either.
I personally find this unreasonable and totally unacceptable.
I too in interim have to pay the new Medical Aid from 1 August 2018 when my Membership with them starts.
PleSe as a matter of extreme urgency can you investigate this matter and revert back to me soonest.
Kind regards
Colleen Smart
[protected]
COLLEENSmart.[protected]@gmail.com

I have been with Fedhealth for years, and they service is getting tremendously worse every year. My daughter has a very rare disability, and requires to have chronic medication, this must be part of PMB. Fedhealth refused to pay until the Paediatrician Neurologist had to write a letter of motivation, which even for him was absurd. The issue all started off when I had to change my member number because of my wife going off the medical aid. This was a huge issue and took a least 4 months to sort out, I was not moving Medical Aids, Just moving Member number (Not that difficult) then when the new member number was issued the chronic medication was not moved over as specified in the application document, so I only recently found out when my savings was depleted and in my enquiry found out that the chronic medication was being covered by our savings. So once again, I was request to resubmit the doctors letter, this was in April 2018. This was suppose to take only 10 days to sort out and put the funds back into the savings, its now the 25 June 2018, I had to call the call Centre again to find out what was happening and now there is a new story. They can only approve 30 tables and not the 45 tables that's been prescribed by the Doctor. now they want me to send them the doctors script to see what he has prescribed.

This is absolutely rubbish, the we as a parent of a disable child need to fight Fedhealth to keep our child healthy with medication that was prescribed my the Paediatrician Neurologist. There is no sense of urgency nor is there any sense of remorse in this situation. I will consult our lawyers going forward.

I am a member of fedhealth maxima basis, member number; [protected], I have been for over 8 years now... But I think that it might be long over due to change to another medical aid because I am sick and tiered of feeling like I am being robbed every month.

On my plan you get 2 free dentists visits per member each year, in December 2017 I contacted the call center to make sure which dentist do they cover. So I have been making sure that I visit the dentists that they cover to avoid non payment... Well that did not happen, first they just didn't pay the account and I had to contackt them over and over and over to settle the claim, and now all of a sudden they do not cover my dentist any more. They do not inform you about any changes, 3 visits down the like the dentist is telling me that they haven't paid and when I phone to find out why, all they offer me is that the dentist is no longer on their provider list. Not that that would have maid much of a difference because they don't pay them out either way. When I requested that I would like to talk to a manager I was informed that there is no one available until after 1 pm.

I feel that it is only fair that they cover the costs that I incurred due to their negligence, its not that hard to just send out a generalized email to inform your clients when a doctor or dentist lo longer wishes to be on your system... Or at the very least when I kept on using the same dentist they should have just informed me that there has been a change.

I called on the 7th of June to follow-up with payment as my son went to see a doctor in hospital- its been more than 2 weeks that i have been calling the fed-health medical Aid and still im not helped they keep telling me that they will get back to me but none does

they have been giving me reference numbers for calls-070618qtk4xj the name of the person who i have been dealing with is Anthony

Im total very upset and disappointed because very time i use the medical i experience problems and it takes for ever to get resolved.

Good day, [name removed] was given authorisation to have her wisdom teeth extracted at Milnerton mediclinic but after the procedure accounts that should have been covered in hospital including the hospital bill have not been paid by fehealth and are sending it to Me. Please assist as I am ready to cancel my medical aid fore this poor service, member number [protected]

Thank you

I submitted a letter to the management board of FedHealth regarding a medical aims query. Thereafter, I received no updates. Please see details below:

I have called the customer contact centre numerous times in an effort to reach someone in the credit department, with the following  results:
On my first call, the consultant hung up on me.
On my second call, I was promised to receive a phone call back or an email with a status update.  I did not receive this.  Call reference number: 250418qrkr9k.
On my third call around 19:30 on 26/04, I was again promised that the consultant will follow up with Belinda Pretorius (the lady handling my query) at 11:00 this morning and revert back to me, which did not happen.
All my other calls were unanswered, I was cut off or just left holding the line for +-20 minutes.
I called three times on 26/04, only to find out that the credit department was on a team building exercise and that all call centre superiors were apparently in a team meeting.  I was promised to receive a call or email back, which again, was not the case. 
No out-of-office message nor apology for not being available was ever sent.

Good afternoon

JRP Bouwer member number [protected]

Below is my email and Dr. Gelbart's and to date we haven't received any response.

My dad had to pay a R25 000- co-payment on a knee replacement and we are very upset about this and would like the matter escalated to your board for review.

My dad is a pensioner and can ill afford this co-payment. In light hereof, we approached Fedhealth as Dr Gelbart who is not contracted into ICPS, is willing to do the procedure (and to get all other service providers on this case) at ICPS rates. Our request was for Fedhealth to wave the co-payment in this instance. We were informed that the co-payment cannot be waived even if the doctor is willing to charge ICPS rates. A reply of "Sorry, this is just how it works" cannot be accepted.

With the knowledge at hand, we believe that Fedhealth will not be prejudiced in any way by waiving the co-payment and we feel that to decline this request is an unfair practise.

We enclose the doctor's comments below and look forward to your favourable response.

Regards

Groete/Regards
Martin Bouwer
CFP®
[protected]
[protected] fax/faks
Steve Jones & Associates CC
An approved financial services provider
Gelisensieerde verskaffer van Finansiële Dienste
Please note that calls to my cell from "unknown" or "private numbers" are
automatically blocked

From: Dr Brad Gelbart [mailto:[protected]@linksfieldkneeclinic.co.za]
Sent: 02 February 2018 05:32 PM
To: [protected]@iafrica.com
Cc: Elsabe Klinck ; Elsabe Klinck
Subject: Copayment for total knee arthroplasty - MR J Bouwer

Dear Mr Bouwer

Thank you for contacting me regarding the co-payment for your father Johannes Renier Petrus Bouwer's knee replacement scheduled for 06 Feb 2018 at the Linksfield hospital.

As I mentioned to you, I am not contracted into ICPS as they are prescriptive and there are currently questions over the ethicality of the set up.

I am happy for you to propose to Fedhealth that I am happy do the case at the bundled fee that ICPS is charging Fedhealth.

I will speak to all service providers to ensure we come in at the same fee.

Please contact Fedhealth and explain to them that I have offered this. According to law they cannot refuse to allow you to have me do the procedure at the same cost.

I have contacted them numerous times with my partner Dr Firer to offer this to their clients but they have constantly ignored us - all the way to the CEO.

I have cc'd Elsabe Klinck who can advise you more completely on the legal issues.

Let me know you need anything else

Regards

Brad

Dr Brad Gelbart
Orthopaedic Surgeon
Linksfield Orthopaedic Sports and Rehabilitation Centre Centre For Sports Medicine and Orthopaedics
24 12th Avenue 9 Sturdee Avenue
Linksfield West Rosebank
Johannesburg Johannesburg
+[protected] (rooms) +[protected] (rooms)
+[protected] (mobile) www.sportsortho.co.za
[protected]@linksfieldkneeclinic.co.za

Client number: Mrs. CJ Maans - [protected]
I missed two medical aid payments, for January and February 2018. On 19 March, I contacted Fedhealth to ask them for banking details as I wanted to pay the instalments which were outstanding. The consultant I spoke to said she would email the bank details to me but that the instalments might be able to be processed via debit order. I waited for the details but it never came through. I called them today to ask for bank details again but they said the membership was terminated as they sent me an email on 23 March which I did not respond to. They had my incorrect email address (a mistake on my part) but it would have been returned to them unsent as the address they had did not exist. I offered again to pay the outstanding amounts but they said that membership was already terminated, this despite it not being 90 days yet. I would have preferred paying the outstanding amounts and continuing the membership but they terminated before the 90 day period was up.

since December 2017 we struggled with Fedhealth not solving in Hospital bills .Their monthly statements change for same docters and dates .
The savings account is a mess!
In hospital accounts is paid and then just reversed without any reason.
We have to ask every month for updated statements and when eventually sent, the amounts differ.
Superviser do not even reply to an appointment .They DO NOT come back regarding complaints by phone.
I get no help regarding fedhealth not solving the members account and savings.

As we have moved to a new location, we have been battling since November 2017 to change personal and bank details with Fedsure Medical Aid. Although we are reminded that we can change details on-line, such on-line changes are not possible.
In the interim, we received a notification that an amount are due to us. We submitted four requests to understand what the money is for and in which bank account it will be paid as the bank account on record does not exist.
The only response is that money is due to me and a schedule of payment dates.
it is impossible to deal with any responsible person at Fedsure medical aid or there administrators at Medscheme. They hide like deeper than any gold mine in the world leaving incompetent employees to deal with you, which do not happen either.
In the mean time we are required to pay our premium on time. Clearly so that our portion can be used towards salaries that further the patronizing incompetent ignorance of employees at Fedsure.
Clearly, if someone are hiding like that it only confirm that Fedsure are undulated with problems and that the principle management are unable to deal with matters.

Goodday,

I received an email stating my cover has been terminated. I have not given permission. I said in the email I want to continue privateley, by paing the full amount myself because Im not with my previous employer. I am going for a gynae check up thursday.. What a mess. Now Im worried where will I get the money to pay in full. Why isnt there an option that asks the customer like many banking apps: 'are you sure you want to terminate' because then the customer and the consultants will be on one page. What I say and what you read is two different things now im without cover. I am upset and worried.

Shena
[protected]

I changed my fedhealth option on the advise of my then broker at the beginning of 2016 believing that I would be covered for all medical requirements. I had been for a arthroscopic of the knee in November 2016 where the surgeon advised that a Knee replacement is strongly advised or alternatively I would have to live on pain killers.

As this procedure had cost me in excess of R20 000 over medical aid benefits, I also took a gap cover effective 1 January 2017. As there is a one year exclusion for a pre-existing condition, I continued with pain killers for a year.

When making enquiries with the Fedhealth Call centre last week (3 rd week of January)- I was told that my option does not cover the Knee replacement. I asked if I could change my fedhealth option to the one higher (option covers the knee replacement) than my current and was advised that option changes were finalised at the end of November.

As I am aware of the additional stress upon the system when a change is requested, this is a rare exception. It is also the first month of contributions at the new rate. Surely this exception could be made.

Await your response.

On the 2nd January 2018, I call Fedhealth Call centre to get authorisation for surgery that my 5 Year old Daughter needs to have.
Only to be told that my daughter has an exclusion for her tonsils. This was the very first time I heard that she was excluded for this condition. I joined the medical aid on the 1 October 2017, ONLY received my letter of Membership on the 3 January 2018 . How Convent for Fedhealth to all of a sudden send me this document when I need to send my 5 year old for surgery .
Fedhealth Declined The tonsillectomy, The Bilateral Myringotomy, Mucoid Otitis Media, The Incision of both eardrums, Nasopharynx including a Biopsy and the removal of the Adenoids .
I was then told that the Doctor would have to write a letter explaining that this is an emergency operation and explaining how her condition with cause other medical issues should she not have this procedure done.
I went and got all the paper work that they had asked for and sent it through to Fedhealth, Only to be told that someone would call us back …. Which never happened .
I then took to Hellopeter to get Fedhealths Attention ….
I eventually had a lady by the name of Phindile Hlalukana call me, I explained my situation and she said would get back to me once she has spoken to the Fund Manager . After a few days I still had not heard Anything for the fund manager, the underwrites or Mrs Phindile Hlalukana . I have sent out a number of e-mails ect, Not one person has replied.
The Lack of interest from Fedhealths management is Disgusting.
Fedhealth is a so called Family medical Aid . Well its Not, I will not recommend Fedhealth to anyone with Children . My child is suffering because of Fedhealth's disgusting management.
It would seem that Fedhealth has NO plan on assisting me in my urgent matter.

Members no [protected]
Clinton petersen
Ref nos 100118qkd1hy
090118qk907r
Consultant ms mbali

At this moment.i am extremely anoid
Last year when I submitted a claim got conflicting stories from your consultants.
About my claim taking so long
This time around I submitted two.one approved the other I get a bullcrap story about a blaze programs client intervention.which I would like to see it's in writing on your website
To annoy me even more I get promised my case will be escalated to a senior and I will get feed back from Mbali by today end of business.(lodging my case on Wed 10 jan).
Today I call mbali. 2.30 pm who advises me .that it's not yet close of business. She's working late.will give me feedback later.(and yes still waiting for her call.) I.asked to speak to a senior. I'm Put on hold for about 4 min
And the classic answer...the team leaders are in a meeting ...enough to upset me

All I want to know is what's the issue with my claim.as it got.rejected due to no savings.when the e n t specialists put it through.resulting in me having to pay in cash then claim from my scheme.which I did
Before I state my case on every possible social media platform.im hoping this matter gets urgent attention
Regards
Mr cm petersen

On Tuesday 05 December I needed to take my son to doctor which was very urgent I called fedhealth and asked them to please unblock my account which I was owing just over R900 and they refused as I told them as soon as I'm done at the doctor I will pay the balance I owe them, after I got to the doctor I paid over R900 for services and than still went to a bank and payed them the R900 which made me pay double the amount now and when I decided to claim back my R900 they refused me, this is not the first claim that has been rejected by these guys I'm just so fed up and don't know what to do at this moment and feel like taking this up on social media, hope this helps me if it does not I'm going to take it further and show the world what [censor] business you guys offer

Ive been a client with fedhealth for over 2 years went on an international medical scheme because of my husbands work then 2 months later i decided to go back to fedhealth just making me the main member but im just not getting any service i should have been back on the medical aid by the 1 ste seeing that i have done the new application but according to the agent that has been helping me im not approved yet it has been a month since my application has been done and i have made numerous phone calls even asking to speak to the manager and every time they tell me she will phone me back and just doesnt phone me i am tired of trying so they can take there medical aid i will rather to another medical that wants to help me!worst service ever!

Hi

I am so confused
I put in a complaint/query regarding overcharging me for my daughters premium – with you having all the required documentation proving she is not yet permanently employed and still falling under a child cover then you send me a new form to complete ? How?My question is why did you do it in the first place if you did received all the info on the 8th of May2017, as well as what are your going to do about it now. I can only complete the form with the correct day once she sign a permanent contract. That will be at the end of June .Please please advise what you want me to do.I need feedback from you

FEDHEATH WHAT HAPPENED TO YOUR SERVICE

Kind regards

Francina Ackerman

Member number [protected]

Good Day

I am tired of contacting Fedhealth's customer care line. I did a change of main member. Mr JH Augustyn became a dependant and I became the main member as from the 1st of January 2017. Ever since that was done I had so much queries about accounts that wasn't paid, mr JH Augustyn being suspenden due to a previous payment from the membership number of witch he was the main member. When I queried the incident I got a mail from me Angel Bithelizi stating that it was a doctor's account that wasn't paid on mr JH Augustyn's membership number due to the change of main member, and that I could send a letter stating that I give permission for the medical aid to decuct that outstanding account from my savings account. That already happened on the 29th of March 2016! I have been hence and forth between my pharmacy trying to collect mr Augustyn's cronic medication but with no success. The printout that I got from Dischem today about why the medical aid is not paying his medicine stated that code 632 Real Time claim received during member suspension!

I phoned the customer care line this morning before going to the pharmacy to confirm if the suspension was lifted. I was send a proof of embership by the consultant stating that there are no suspension and the membeship is active.

The reference numbers that I got on the 31/3 when I phoned the customer care line to find out if the suspension was lifted was 310317Q717NB. The Lady named Angel said that the did receive my letter and are attending to the matter.

Ont he 3rd Of April 2017 I phoned the cronic department for another query and I spoke to Heinz, when I mentioned to him what happened he told me that according to the system the Letter was refered to another department.

On the 18th of April I phoned again, thinking I was giving them enough time so that it could be sorted. I got a Ref no 1804172Q7NFJL. It was said that the suspension was not lifted.

This morning when I phone I was told that the suspension was lifted yesterday?

I want answers... I had to pay for the medication in cash because mr Augustyn have been withour his cronic medication for more that 2 weeks already...

I need you to please pay urgent attention to this matter. If I canot get any answers I will have no choice as to take this matter thurther.

Thank you

Me E A Augustyn

I will be able to send the proof of correspondance if I can get a valid email address.

I did a pap smear test and obtained results that I have high grade abnormal cells, which if not treated will lead to cervical cancer. Pre authorisation request was sent to Fedhealth on the 13th of September, and I have every reason to believe that my case was not handled with a sense of urgency which to me is BAD service and a bad experience for anyone in my condition to go through. I have co-operated and went out of my way to try expedite the process of getting to an outcome of the non disclosure investigation. each time i call, it would seem i trigger some action from the investigation officer, she would request info and despite me responding when i call to frollow i get a response that she has received my email. No sign of being dedicated, pro active and willing to assist. it almost seems as though she is doing me a favour or is trying by all means to reject the pre authorisation request.
i appreciate that it is procedural however based on the poor performance by the underwriter, i have tried on numerous occasion to contain my frustration but honestly feel let down by Fedhealth. This is affecting my health negatively and i have shared this frustration telephonically and via email which i am happy to share. To this day i am still trying to establish what it is that i did not disclose for an investigation to be underway. i am more than happy for Fedhealth to go through with their processes, but i also believe that they can treat things with a sense of urgency as we are dealing with people who's health might be at risk, this is a medical scheme afterall.

I was told, all schemes approve Asthma as Chronically, no matter which plan I choose. The "low" plan I did choose, to fit my budget, does not approve pills only inhaler! I need the medication for my 3year old to prevent Asthma attacks, but no-one is helping me to over come this issue!