LL
Levona L

1 reviews | Active since Nov 2020

30 Jun 2025, 10:49

Bad service from Medical aid

Good day, I am writing this email regarding promises that are being made but every week is the same story. I received an authorizing number for a CPAP machine that was accepted in April 2025. I then went ahead and paid cash for the machine in the mindset of claiming it back from the medical aid. Please note that I am on the Platinum Advance option and at the moment paying for 4 x Adults, so it is not a little bit of money that I am paying. Regarding the refund I have phoned them every week and at first, I was promised that it would be the next pay run which is on a Monday. Today I phoned and being told that the claim was rejected. The authorization number is NEO***A. I am really getting frustrated with this; it is not only that last week I fought with them regarding my daughter that needs an appliance for her foot as she had an AVM in the brain which caused bleeding on the brain. She had radiation in 2022 and as a result from that she now has necrosis on the brain. She has been medically boarded from December 2023. The medical aid only wants to pay R3600 and state that this is not a chronic illness. I don't even know why we pay all that money if we have to pay majority of the medical expenses our serves, maybe it would be better just to put that money into a saving account and look at a hospital plan instead.

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply30 Jun 2025, 11:38
Official
Dear Levona, 

Thank you for submitting your query, and apologies for the inconvenience caused. 
Thank you for the provided query reference numbers. We will look into this and escalate the query for urgent attention. 

We appreciate your patience. 

Your Choice for Quality Care
 Sizwe Hosmed team