Medihelp
Reviews and Complaints

Medihelp terminated my membership without me being aware or officially informed of such arrears. The prescription period of time protects both the debtor & creditor. This was not applied my september debit order was reversed as my bank temporarily closed the account to investigate fraudulent transactions. I called medihelp and made an eft payment immediately. Medihelp failed to allocate the payment, account placed in arrears and unfairly terminated

Have been in excrutiating pain for 10 days. Cannot use pain meds. Ct scan shows I have a hematomia 10x3x4cm on my kidney and already my kidney started dying. Medihelp saw CTScan but does not want to approve angiogram to close bleeding veins. Looks like they will rather pay for a removal of my kidney and all the risks involved and fees in ICU.

Have not been in hospital for more than 14 years. I do not have time for other motivations and baord meetings. I am sick

I missed two instalments however I called medihelp to make an arrangement and they give me until the 20th september 2021, on the 20th l paid and they still terminated my account and refused to reinstate me. They said I should've paid before the 20th. Instead they said l should reapply, which I did. But not happy about. My husband is on chronic medication please assist.

I am a service provider and have a client who is a Medihelp member. I submitted accounts directly to Medihelp. On the statement I have my current bank account details Medihelp remitted a payment into an account I closed in 2012. (They still had the old details on their system even though the BHF have had the correct details since 2012). Medihelp have refused to instruct their bank (ABSA) to recall these funds although I have been told by numerous bankers that this is the accepted process and the only way in which I can access the funds.

I went to hospital 4 O F JUNE 2021 with approval from Medihelp
also for 5 days and 1 ICU day
now the hospital is finished and they send me a account they will only pay R23 000 for hip find attached the approval.
tie was approved for R61583-00
Also eugene MArais hopsital is charging me for 2 ICU day when I was approved by mediheltp for 5 days + 1 ICU day
Eugen Marais send a 2 day ICU bill for R12500 per day so I have to pay R25000-00 I cannot get hold of anybody to sort this out just getting Reference numbers.
I also send proof from doctor that I was in ICU 1 day and also that MEdi help was supposed to cover that as you can see with attachements

regards JC SWANEPOEL - Medi help Member : 7966850

Membership was cancelled for missing 1 months premium, fine, then my Mother In-law had to re-apply for new membership. The Application was submitted on 19 Dec '19, with no response until the 16th of Jan '20. We're by Medihelp nearly doubled the monthly prescription, for late joiner penalty, but they where members a month before that at Medihelp with all the history needed. Letters has since been sent up and down, and with further info requested from Medihelp before they could consider the application on the 11th of Feb '20. We got everything and submitted it on the 18th of Feb'20, and 9 days later, still no answer. Meanwhile my mother in-law fell and broke her hip, where they should've been covered by Jan already. The service is absolutely poor...

I have submitted my request to cancel my membership subscription due to the termination of my contract of employment. The employer said it's my responsibility because I signed the contract with them. And they are saying they also has the contract with my ex employer. I truly cannot afford to pay any contributions, the little that I have received must pay school fees.

my wife Brigette Katz had a procedure done in Sandton day clinic on NOV 8 2018
We had the correct authorisations in place no [protected] yet Medihelp has yet to pay this account.
when contacted they told me the codes were incorrect and the doctor/clinic had overcharged me.
when i confronted the doctor/clinic they told me that all was in order with codes and the medical aid must pay, that is the same price as they were given when they got the authorisation number.
The doctor who did the procedure was Dr Avenant.
my policy no 6927351
dimension plan 3
kind regards
Mr Yael Katz.

Medihelp seems to have turned in to medionly collects money and don't want to pay. I worked abroad for some years and because my SA medical aid (medihelp) can not provide cover abroad for extended periods I had to join a medical aid abroad. Upon returning and rejoining with proof of having been on a medical aid abroad what do I get a 12 month waiting period for pre-existing conditions. Their excuse - because it is not a South African medical aid the medical aid act does not apply. I have lived in 3 different countries abroad and was on medical aid in all of them. Not once have I had any waiting periods imposed on me by the medical schemes abroad. What is the use of being on a medical aid and paying them every month while they refuse to pay for things? Why get penalized for being on medical aid abroad while this medical aid could not provide the service anyway? All I can say is I am pretty tired of service providers in SA in general who have much much higher fees and provide services so sub par it can't even be compared. I have to be on a medical aid coz if something happens in SA you need it but I might as well not have one it is like flushing money doen the toilet for a year due to their poor excuses. My family has been with medihelp for 23 years but it seems it is time to move from this greedy scheme.

Yesterday Night my Husband was taken to the Springs Parklands Hospital due to that he passed out while taking a bath.He was complaining of Lower pain on the right side of the Pelvic area.The Emergency Doctor looked at him and contacted the Specialist Surgeon Dr C.Snowdowne due to that my husband saw him a few months ago due to being referred by our GP Dr.Doorgha.

He was admitted in the Surgical Ward due for a emergency operation the next morning.
We were told that the Theater and the Hospital was waiting for the Authorization.

The Lady by the name Brenda Piper was assigned to work with the Investigation due to that we are only 6 months on the Medical Aid.We were told that they will speed up the process because it is a emergency.

By 12:00 pm a Lady from the accounts department told my husband that they are going to ask him to leave the hospital because he is there without any Authorization and did not make a 50% deposit payment.

We then phoned the Dr to Discharged my husband because we do not have that Big amount of money in our accounts.

Now I phoned the Medical Aid once again to here how far the Investigation is and I was told that BRENDA PIPER went home at 15:00 pm.SO what about my husbands operation what about the pain that he has.

Petro Scherman told the operator to tell me that she knows about the Case and she will sort it out tomorrow.

THIS TO ME IS VERY UNACCEPTABLE BECAUSE WE PAY ALMOST R8000.00 PER MONTH AND THIS IS THE SERVICE WE GET.

If I do not receive the Auth Number by tomorrow I WILL MAKE this Public.

There are better Medical Aids out there But we Choose to use your service and we get a Slap in the Face Because you cannot No wait WILL not help and Emergency pasient.

I can be contacted at [protected] if you want to make me a happy client and want me to stay

Greetings

After submitting a refund of a credit balance due to me from Medihelp, I was sent a form to complete as well as aknowleding the amount owed to me.
I sent all the required information including their acknowledgement of the amount owed to me. Unfortunately I have not had a medical since 2014 and had no new scheme for the funds to be transfeered to hence my request to Medihelp to pay into my bank account.

I recieved the following response :...
..."​Your request to refund your savings account credit cannot be approved, since the request was not received timely"

Medihelp still has a statement reflecting the balance owed to me.
Is it legal for Medical aid schemes to withhold credit amounts due to their clients?

Regards
Georgia
[protected]@gmail.com

Date: April 2018
Contact details: [protected]
Medihelp Nu: 5929598

We have enquired to get a pair of glasses for our daughter, Anschia Pauw, who is a dependant on our Medical Aid. She was on our medical aid up until end of 2016 when she returned from the states we added her back onto the medical aid. Medihelp advised that she is a new member and needed to wait for a three month period before she can claim. Long after the waiting period We had her eyes examined, after which PPN could not put it through on their system as they say that Medihelp has not loaded her as a new client.

I then called Medihelp and spoke to Chantelle, who got back to me, saying that PPN only allows a claim within a 24 month period. The optometrist has spoken to PPN and they advised differently. They advised the following: "said that if Medihelp confirms that she is a"new"member, then they are able to change their system, however Medihelp needs to inform them accordingly. As far as I understood the consultant said that they will change their system as they need to go with Medihelp's rules, so if Medihelp sees my daughter as a new member on their system, then they need to do it the same for optical."

I am highly upset that this matter is dealt with in this way as my contact with Medihelp states a three month waiting period and according to PPN you needed to update your system. Medihelp gives contradictive answers to a claim. I would like Medihelp to do what they say in their terms and conditions and allow us to get a pair of glasses.

I am on a PRIME 1 NETWORK plan, have been with Medihelp since 2014 and have never claimed. 4 weeks ago I was diagnosed with multiple sclerosis, which is degenerative autoimmune disease. As my service provider, Medihelp was made aware as I needed chronic medication to be approved. We have been in communication for the past four weeks and after receiving confirmation of the approval, (which took three weeks to obtain) I called them to make sure that everything was in check. They then told me that there was a co-payment to which they are only paying for 40% of the total amount as the medication I have requested is not on their reformery list! I have been in communication with this company about a chronic disease and in four weeks not once was this ever sent to me or brought up. Had I known, my neuroligist and I would have chosen a medication according to their list. I find it absolutely disgusting that they treat their clients like this, especially when dealing with chronic diseases. I have called in about four times regarding this and no one has assumed responsibility, instead I get told that I have 2 options, either I choose a medication on their list or I pay them more each month to go onto a better network! I'm shocked that after wasting 4 weeks of my time and given me the worst service that I'm being asked to compromise or pay them more money. I think it's now up to them to compromise and amend the relationship. This has caused me unnecessary stress when in a very vulnerable state. I expect a lot more from the people who take my money every month without question yet when in need it is struggle to get them to help.

This review was originally posted on 21st June and no one has bothered to get in touch with me.

Sent: 30 November 2016 12:05 PM
Subject: Medihelp membership number 7663552- Code 02-rejection of hospital stay claim 11 November - 17 November 2016

To who it may concern

On 11 November 2016 I spent the whole day in pain and decided that evening to go to L&D as I thought it might be early labour at 28 weeks and 5 days where they admitted me.
13 November the Dr still did not know what was wrong with me where the hospital sent in to Medihelp for hospital authorization but unfortunately with that there was a urine test that was positive for a UTI ( I have a exception till next year) they also thought it was a break hence the surgeon coming to see me. On 14 November they found out that the extreme pain was actually a 4.6 cm Fibroid degenerating due to the tumour not getting ample blood supply any longer as the baby was taking it and it was infected.
The hospital did update medihelp and my Dr. sent 2 letters stating that the diagnosis was not a UTI but a Fibroid however Medihelp is still refusing to pay for my hospital stay due to the urine test. (Makes me wonder if you cannot read my Dr. handwriting)

How were they suppose to figure out what was wrong with me if they couldn’t run any tests? Now I cannot have my delivery of my baby at Linmed hospital or go with the OB I have been seeing right through my pregnancy because of Medihelp and their money grabbing stuffed faces.

Please see below some info on a degenerating Fibroid and that it has nothing to do with the bladder as my Dr stated to you in the 2 screen shots of the letters my Dr sent through to Medihelp. Also see sonar of my 4.6 cm fibroid that everyone seems to be missing or chooses to ignore so in the end I was not in Hospital for a uterine infection although it was present but a infected degenerated Fibroid.

This is my last attempt to communicate with you, after this I will go to Ombudsman and social media posting this exact letter and the screen shots as any logical person knows diagnosing anything medical or non medical is a process and you chose to look at the beginning of the process and got stuck there ignoring the final conclusion of that diagnosis, you will have the exact same argument if this happened to you or one of your family members.

(Lets say I got a kidney infection and due to that went into early labour where they had to deliver my baby girl, what you saying is that you will not cover the cost of that delivery because it was caused by a kidney infection that comes from a bladder infection.) Does that make sense to you?

Two week ago i submitted forms to medihelp for a minor sinus operation for my son. It's 2 WEEKS now and still waiting for a number. keep on moving operation date... my son get's sicker and sicker day by day. Tessa Venter the person responsible for my case just takes her time. Apparently they will seek every single excuse not to admit my child or pay for this procedure. Please tell me what the heck the problem is this time? New investigations about previous sinus operations? HE DID NOT HAVE ANY TREATMENT NOR OPERATIONS for any sinus problems previously... Again i need to phone and cancel the hospital, doctors and specialists. Worst medical aid ever when it comes to their admin.

After I resigned from Medihelp, they told me I owed them R3118, 00 for my savings account I used. I am not sure why they call it my own savings account, as they did not cover most of the “over the counter” meds I bought. I agreed, and made arrangements to pay the outstanding amount in 3 months. After I paid the outstanding amount in time, they came back to me and told me I owed them another R8.15 for late payment; the reason for this is; I did not mail them the proof of the last payment in time (although it was made in time). Michelle Dewrance, the accounts contact person, was not helpful in the event, and very rude during all communications. I did pay the outstanding amount just to get rid of them, and hopefully never hear from them again. Please think twice before joining these guys!

On the 30 of December 2011, I phoned medihelp and informed them I no longer wished to be a member of their medical aid. On the 5th of January they were notified via email of the above as well. I received no response from them and on the 2nd of February 2012, I sent another mail, I also cancelled my debit order for medihelp. On the 12th of march 2012, I received an email from medihelp demanding payment from December 2011 till April 2012. On the 21st of May, I spoke to L.Bosman confirming the above, however she refuses to accept the facts. I feel that I am not responsible for this account, as I have followed all the rules. I would appreciate your assistance in solving this issue speedily. Thank you. Your sincerely surina van Deventer

I really thought no one can beat disovery healt but you guys just did! what is the point of submitting your medical certificate of previous medical aid and then when your GP refer you too a GYNY you have to be interigated first and then still need to submit this certificate. called the call centre to compalin got refer to prime cure network - so who am i know actually paying to have this medical aid? and off course the broker does not return our calls now - happy to sell it - well your sales agents - but no one tells you how bad this prime cure is and why no one wants to be on it - not even dr's since they actually loose business! so how bad is it then appon investigation today that ALL service providers even complained about this and poor payments from your side! we would like to speak to a person who actually knows what is happening and assist in cancelling our medical aid - the JOKE is that even if we willing to pay to be on a higher medical aid with you - we not allowed to do this till Nov with the change being effective from JAN 2011!~! so you want R1100 a month for 12 months just to give me hell each time I do dare to get sick - heaven forbit! this is a joke !

I am highly disgusted with this medical aid! I joined a medical aid to enjoy the benefits and for peace of mind, but it has caused more problems than any thing else.

I was recently referred to a specialist. On the 3rd of February 2010 I called the customer service line for the first time to arrange this. I then called every 2nd day to follow up on the authorization. But was only told I will receive feedback soon. During the first week i called again as the authorization was now taking more than a month, and i was told by the call center it would take 4 days max.

On the 15th of March I decided to email Medihelp. Only on the 17th of March i received an email from Rozanne Nel stating they are awaiting feedback. This means nothing to me and is an unacceptable answer.

Only on the 6th of April did Bridget Groenewald reply to my email stating that the doctor hadn't filled in the form required. I cannot understand that it takes Medihelp more than two months to notify me that they are awaiting papers from the doctor, after I had made several calls.

Surely this is unacceptable client service. I cant recommend this Medical Aid to anyone if this is the kind of service one can expect.

I went to a specialist on 5 December 2010 – I paid him in full and send the account as well as proof of payment to Medihelp via email on 15 December 2010. On 7 January 2011 I learnt from them that they refunded the doctor for 2/3 of the amount and that the rest of the money will be paid into my bank account on 20 January.

First of all I had to request the Doctor to refund me – an unnecessary trouble for both parties due to Medihelp’s mistake and secondly after a few emails the money the Medihelp still owes me, is still not in my account.

You cannot get hold of them via telephone – you hold on forever and the general service of them is really appalling and definitely not acceptable