Recommend a medical broker

[Merlin]

Hi everyone,

I've been dealing with an admin' and billing nightmare surrounding medical issues in recent months.

I fired my last medical broker days before I underwent spinal surgery, and I'm now looking to boot the replacement after a series of issues, including an oversight that cost me 25k.

Do any of you have strong recommendations for a consistently excellent medical broker, please?

If it's of consequence, I'm with Medihelp, and Sanlam for my gap cover.

Thank you.

 

[airborne]

it might be a bit of a challenge considering Medihelp is not so widely known.
What are they like as a medical aid?

 

[Merlin]

it might be a bit of a challenge considering Medihelp is not so widely known.
What are they like as a medical aid?

I've been with Medihelp, barring about three months where I was forced onto Discovery due to a short-lived job, for about two decades now.

In that time I've shifted plans a few times, was on PMB medication for several years, and this year have undergone spinal rehab', and spinal surgery. Barring them rejecting one procedure as part of my spinal surgery, and two minor account hiccups thereafter, which have now been satisfactorily resolved, I've never had any other issues.

 

[airborne]

I've been with Medihelp, barring about three months where I was forced onto Discovery due to a short-lived job, for about two decades now.

In that time I've shifted plans a few times, was on PMB medication for several years, and this year have undergone spinal rehab', and spinal surgery. Barring them rejecting one procedure as part of my spinal surgery, and two minor account hiccups thereafter, which have now been satisfactorily resolved, I've never had any other issues.

Interesting, I’m a little afraid of leaving Discovery but I do really want to, what a useless company they are, the support is absolutely garbage. I’m being a bit stupid because literally millions of people use other medical aid schemes.

 

[SauRoNZA]

I’ve not found these guys to ever do anything more useful than sending an annual price increase letter…which the medical aid sends you anyway.

I reckon skip the middleman and just do it directly.

How do you reckon they cost you 25k?

 

[RedViking]

I’ve not found these guys to ever do anything more useful than sending an annual price increase letter…which the medical aid sends you anyway.

I reckon skip the middleman and just do it directly.

How do you reckon they cost you 25k?

My previous broker for insurance was very useful and kept Santam on their toes. Sadly he passed away and the new lot that took over is pretty useless.

I can imagine if we had a good broker for MIL's Bonitas they would probably have sorted things out for us and take away a majority of the stress in this mess. However to find that broker is probably near impossible

 

[Merlin]

Interesting, I’m a little afraid of leaving Discovery but I do really want to, what a useless company they are, the support is absolutely garbage. I’m being a bit stupid because literally millions of people use other medical aid schemes.

I refuse to deal with Discovery, on principle. Their ethics leave a lot to be desired, IMHO.

I’ve not found these guys to ever do anything more useful than sending an annual price increase letter…which the medical aid sends you anyway.

I reckon skip the middleman and just do it directly.

How do you reckon they cost you 25k?

The first broker I booted assisted me with navigating the particulars around the spinal program, identifying approved specialists, the initial pre-authorisation, etc..

I booted him because I wasn't getting timely responses, and because when he didn't know something, he shrugged his shoulders rather than doing the work to find out and assist, with my surgery fast approaching. If we got it wrong, I'd be on the book for a large chunk of it.

The current broker stepped in at the 11th hour to assist with getting the pre-authorisation over the line, and discovered that we needed the same for my gap cover. She was initially very helpful with managing the claims after the surgery, but that initial enthusiasm rapidly faded, and again I was left without answers.

Her office was supposed to put in two claims mid month, to ensure payment of the one specialist in time. With a couple days to go, desperately waiting for the incoming funds, I learnt that they had not submitted the claims. To avoid hefty interest on that account, which would have been for my bill, I opted to draw the sum from my investment fund to clear it in time. I'm now waiting on gap to repay that amount.

I was hit with a run of bad luck outside this medical debacle at the same time, putting me in a precarious financial position, which the broker was aware of. They've not responded to my gripe, so frankly, I feel rocks about booting this one too.

My family make extensive use of an insurance broker for other insurance as we have some special requirements. The use of a broker has proven notably helpful when the proverbial doodie hits the fan. Medical insurance is no different. When you need it, having the backing of a good brokerage pays dividends.

 

[SauRoNZA]

My family make extensive use of an insurance broker for other insurance as we have some special requirements. The use of a broker has proven notably helpful when the proverbial doodie hits the fan. Medical insurance is no different. When you need it, having the backing of a good brokerage pays dividends.

You say this, yet by your own evidence it doesn’t seem to be true at all.

If you had claimed directly it would have been timeously and you would have known it was done.

 

[airborne]

I refuse to deal with Discovery, on principle. Their ethics leave a lot to be desired, IMHO.


The first broker I booted assisted me with navigating the particulars around the spinal program, identifying approved specialists, the initial pre-authorisation, etc..

I booted him because I wasn't getting timely responses, and because when he didn't know something, he shrugged his shoulders rather than doing the work to find out and assist, with my surgery fast approaching. If we got it wrong, I'd be on the book for a large chunk of it.

The current broker stepped in at the 11th hour to assist with getting the pre-authorisation over the line, and discovered that we needed the same for my gap cover. She was initially very helpful with managing the claims after the surgery, but that initial enthusiasm rapidly faded, and again I was left without answers.

Her office was supposed to put in two claims mid month, to ensure payment of the one specialist in time. With a couple days to go, desperately waiting for the incoming funds, I learnt that they had not submitted the claims. To avoid hefty interest on that account, which would have been for my bill, I opted to draw the sum from my investment fund to clear it in time. I'm now waiting on gap to repay that amount.

I was hit with a run of bad luck outside this medical debacle at the same time, putting me in a precarious financial position, which the broker was aware of. They've not responded to my gripe, so frankly, I feel rocks about booting this one too.

My family make extensive use of an insurance broker for other insurance as we have some special requirements. The use of a broker has proven notably helpful when the proverbial doodie hits the fan. Medical insurance is no different. When you need it, having the backing of a good brokerage pays dividends.

I've had a similar experience, very helpful when they actually put some effort in but they need a solid kick in the pants before they reach that point. I had an issue with Discovery last year and the lazy cow who was assigned to my case at my broker totally ignored my question and just replied with the same generic garbage I got from Discovery. I had to cc the big boss and ask him what's the point of having a broker if you aren't going to help me, then suddenly my case was reassigned and I started getting actual answers, they still made me wait for days sometimes though. As with anything finding high quality service providers is difficult.

You need to find a broker that cares, when you are navigating a serious medical issue along with the bs from the Medical aid the last thing you want is a fight with your broker just to do their job never mind go above and beyond when you need it.

 

[RedViking]

I have a similar issue as op. Urgently need a broker as we can't manage the nightmare anymore.

 

[Merlin]

I have a similar issue as op. Urgently need a broker as we can't manage the nightmare anymore.

I ended up going through my medical aid, who then assigned me a new broker.

I consulted with them regarding my gap cover too, which I will gleefully change next month.