FedHealth.co.za / Fedhealth Medical Aid

Don't let these corporates take advantage of you... Fight back! I did & won my small claims court case against fedhealth medical scheme for not wanting to pay for the birth of my daughter. When the medical obudsman even told me that "I should speak to the president if I have a problem", I wasn't too convinced that the justice system would come through for me... But guess what... They did! I've joined a medical insurer now & I cannot tell you how happy I am about their service, integrity & ethical manner in which they treat me (Unlike fedhealth). If you belong to any medical aid, especially fedhealth medical scheme, I suggest you re-eveluate your options & find out exactly what you are covered for.
I even received the baby bag & goods, only for them to turn around a month before the birth to say that they will not pay! The ceo, katy caldis, was too lazy to appear herself (Which already says alot about their service) & sent someone who had absolutely no idea about the case. Md, kevin aaron, also too busy to even respond to your communication to him & I hope that if you belong to the scheme, that you will heed my call & "get out!". They paid me a day after the verdict, so goes to show that they will have to adhere to the courts decision & for those who don't know... They cannot have legal representation in the small claims court! Take them on face-to-face (If they're "man" enough... Unlike fedhealth!)

In short, if you're being wronged & you have a solid case against any big corporate... Take them on! The justice system is great & now that the small claims court have increase the claim limit from r7000 to r12 000... What do you have to lose!

Go get'em south africa!

Fedhealth is not to be trusted. I have had a query with them since 6 January 2010. They unilaterally canceled my bank account details saying I put a stop at the bank, which my bank conforms is a blatant LIE, as FEDHEALTH did not present a debit order on my account.

All my efforts to submit claims have been frustrated since 6 January, where they no only currently suspended my benefit again for payments not made (AFTER I they were the one's who incorrectly canceled my details in the first place, I told them to reinstate it from January already, which shows that it was done to late to go through in MARCH!).

I have outstanding claims amounting to thousands of rands which I had to pay cash because of their mistake, and now that I am claiming for my money back, they coming up with all excuses to not pay me. It's either they did not receive my claims (I have emailed proof thereof) or the scans are coming through too light (ZOOM - darken image at printer!). I called on Thursday to speak to a manager at around 15h00. I am STILL awaiting a call from someone from Fedhealth to call me.

They're a useless bunch of incompetent buck-passers who are ripping people off!

First of all your response to my report is incorrect of what transpired since my cancellation. I never received electronic communication advising me of my payment contribution not honored nor that I will be terminated due to non payment or back dating my termination date and advising that you will reverse claims paid. I did request a copy of such notification if it exists. I have not recived a copy of such notification. The membership guide you are reffering to, I did not receive or recall reading, I would have expected you to advise me of that condition the day I spoke to you lady on the phone, you have a copy of the voice recording please listen to it, It was never communicated to me on that day. You poor communication meant I was not covered for a month due to the fact that you terminated me without my concent, I see this as grossly negligent on your behalf and the fact that you reversed claims paid to providers. What you also fail to admit in your response is that I did pay you but you returned my payment. I have requested that you revert the matter to an independent dispute committee.

I joined Fedhealth as from 1 October 2009 as a dependent as I was not happy with my previous medical aid (I was on my previous medical aid for 2 years and 8 months). Since joining I have not yet had a pleasant experience!

I received my member certificate on 1 October 2009 and it had a 3 month exclusion clause on there. I enquired as to the reason for this and what it entails. I did not get any response and therefore phoned the call centre on Tuesday 6 October 2009 at 16:35 and spoke to a lady that told me the exclusion is only for hospital visits where it is not an emergency. She told me I could visit a doctor or dentist etc and I specifically asked if my Yasmin prescription will be covered yet. She said yes, as from 1 OCTOBER 2009 I will be able to get this from any pharmacy.

The very next day Mojalefa Maega eventualy responds to my email, saying the complete opposite from the lady at the call centre. Stating my Yasmin is only covered after 3 months. I asked for a reason for the inconsistency, still no response!

When I tried to buy Yasmin at the pharmacy I was told it is not covered!

I find this company very unreliable to be taken for its word because everytime I phone the call centre for a request, the response I get is always changing and conflicting - depending on the agent I speak to. Fedhealth is openly not passionate about clients, they seem to only pray and wish that you constantly enrich their pockets by paying premiums and NEVER get sick or if at all you do, they hope you go to a public hospital.

The last time I was admitted to the hospital and I needed a MRI scan, they delayed any authorization until I called in from my sick bed to beg them to approve. They even queried my blood pressure state to make sure I wasn't in DIRE NEED OF A VACATION IN A HOSPITAL by pretending to be sick.

Now my problem is that I got chronic medication from my doc and when I sent it through they refused to put in 2 of the main medications I needed but instead they added Disprin at free will, since it only cost R15. Then I called to enquire after 2 months they responsed that they will call my Doc and ask him reason for giving the medication...First it was BP and now medication...Then I am asking myself what really is the value of being a member of this scheme.

On the 10th of June 2009, the main member was hospitalised. The hospital will not admit a patient without full payment being made up front for which a credit card transaction was made. When contacted, the medical aid indicated that the amount was fully refundable. Documentation was sent as requested and the medical aid on the 13th of August finally made payment - not to the claimant but to the hospital (AGAIN!). Get the money back - of course not. We have been told to start the process again by submitting the paperwork again.

Of course trying to call on the customer care service number is nigh impossible - engaged tone can be heard for up to an hour at a time!

We wanted to move my wife from Fedhealth to Discovery as my employer pays a considerable contribution to Discovery.
Now, due mistake on our part we will be paying for my wife c-section in cash (Total bill R 31 000).
FYI : family of 4 on 1 salary
What happened : My boy was born in July in Centurion. We wanted to cancel with Fedhealth as soon as possible and we made the BIG, HUGE, GIGANTIC mistake of putting the cancellation request through at the beginning of Aug (thinking that contributions are paid a month in advance). This effectively puts our last date of being a Fedhealth member at end of June (NOT END OF JULY).
What happened next:A lot of phone calls explaining and begging them to pay they C-section as we are willing to pay the contribution of July.
They said the following : 'The enquiry related to your claims and termination of membership was presented to our fund manager to consider payment of claims related to your caesarean section if the contribution amount for July 2010 would have been paid. It is with regret to inform you that your enquiry has been declined andwe have attended to your enquiry correctly and in line with scheme rules.

Thanks Fedhealth, you saved money !