Complaint / review text:
As per the Momentum policy for my medical plan (Incentive Option), I am covered for the cost of the growth scan and assumed that, as the blood tests were necessary part of this scan, that these would be covered too. So, imagine my surprise when the claim for the blood tests was submitted to Momentum by the service provider, and Momentum only paid out R248,00 of the R1403,70 total on the grounds that my "benefit limit had been exceeded".in my opinion, if these blood tests are necessary to accurately determine the baby's risk of Down's syndrome then they should not come out of medical savings but rather be covered in full unless someone only has a hospital plan? Otherwise, what is the purpose or benefit of the growth scan?
When I questioned Momentum as to why these tests are not covered, the response I got was:"Blood tests and vitamins are not included in the maternity programme, not because we do not find them appropriate but because they do not form part of the maternity programme and these are paid by the member."
This response is so typical and infuriates me as it provides no logical or reasonable justification!