Sipho Mabena

By Sipho Mabena

Premium Journalist


Enraged Fedhealth members take to social media over problems

'Medical aid is a very complex matter, and many members do not understand the details of benefit structures,' said Hans Rheeders, speaking for Fedhealth.


A frustrated parent has described how she was let down by Fedhealth Medical Scheme, with a daughter in desperate need of hospitalisation due to swelling in the brain sitting in pain, at home, waiting for the claim to be authorised. Venting her anger on the online services’ complaints portal, Hellopeter, last week, the parent said the child had seen a neurologist who said she “needs a lumbar suction” as soon as possible, but that the medical aid would not authorise the procedure. “The service is pathetic and so is the medical scheme. The only thing they do pay for is…

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A frustrated parent has described how she was let down by Fedhealth Medical Scheme, with a daughter in desperate need of hospitalisation due to swelling in the brain sitting in pain, at home, waiting for the claim to be authorised.

Venting her anger on the online services’ complaints portal, Hellopeter, last week, the parent said the child had seen a neurologist who said she “needs a lumbar suction” as soon as possible, but that the medical aid would not authorise the procedure.

“The service is pathetic and so is the medical scheme. The only thing they do pay for is GP visits? Will never recommend Fedhealth,” the parent posted.

On Monday, the scheme’s online team responded that a consultant had been in contact with the complainant and “detailed feedback had been provided”.

Another member, Riaan Steyn, was baffled when Fedhealth Medical Scheme allegedly declined his daughter’s claim because she was seven and turning eight in July.

“As seen in the e-mail from Fedhealth, my claim was declined. The benefit is for children [seven] years and younger. That’s what Fedhealth told me. So my daughter is seven years old and she will be until she turns eight, right? So what the heck?” he said.

The payment of savings refunds back to members have also emerged frequently among the string of service failure complaints against the scheme, as Wesley Thompson could attest.

He said he had been sent from pillar to post for weeks in an attempt to get the savings refund due to him, with the scheme’s administration demanding documents he had submitted countless times.

“It’s pennies [R189] you stealing from me but I am unemployed and for me that is food for a week or [two],” Thompson wrote in an e-mail to Fedhealth.

Hans Rheeders, speaking for Fedhealth, said it has almost 80,000 members and some comments on social media cited by The Citizen were “isolated incidents where the scheme’s service did, unfortunately, fail the member”.

He apologised to Thompson for the delay, saying this was due to some administrative processes not being followed by the consultant.

“Thompson was contacted today [Tuesday] and the matter will be resolved without delay.

“Medical aid is a very complex matter, and many members do not understand the details of benefit structures,” Rheeders added.

siphom@citizen.co.za

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