My pregnant wife signed up with Spectramed last year, we were told they won't cover the birth however after birth mum and baby will both be covered. We agreed and all was good (call was even recorded). 6 weeks after birth the Doctor detected an issue and my wife needed to go in for surgery - we called and they declined. The doctor wrote a motivation letter and they declined again - that wasn't the worst part - these issues we experienced:
What the sales person (directly from Spectramed) promised (recorded call) and when we called for authorization was 2 different company policies,
The call center authorizations refused to call the internal sales person who sold us the product, stating they don't deal or communicate internally - REALLY, we had to call and enquire - the Sales person was very helpful however also said that this was a fine print exclusion,
They promised to escalate and call us back and we still waiting - even though my wife already did the surgery and we paid cash.
From false promises, finding loopholes, stating we misunderstood, to bad communication, to no internal communication.
Anyways we cancelled - I guess having no med aid and Sus-pec-tra-med is the same.
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