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Naledi R

1 reviews | Active since Nov 2013

22 Feb 2021, 10:04

Breast Reduction rejection

I have app**** for BR procedure due to heavy breasts which are affecting my health. I have supp**** all the supporting documents and the DR also submitted motivation to Sizwe Medical aid. I tried connecting with you via twitter but that is not helping as your consultant will call promising me that the appeals committee will call me with feedback as to why they are not authorizing the procedure.

The reason they use to reject me was that I didn't disclose that I have medical problems due to heavy breasts. My question is, how was I suppose to know that in October I will be needing a medical assistance? That I will need a procedure to be done so that I can live like a normal person. It means after joining your medical aid, any decease or medical illness that needs an operation will not be approved, then you will use non disclosure to reject the request.....

I'm so disappointed by the treatment I am receiving as even your call center people don't know how to help me. I submitted an appeal, even now I am waiting for a response.

I had a claim of R1000 submitted in November and gain in December, I am still waiting for the payment to be made.

I thought I was joined the best medical aid when I joined Sizwe, but I guess I was wrong. My pocket is not deep enough :(

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply22 Feb 2021, 10:24
Official
Dear Naledi,

We acknowledge receipt of your comments. One of our consultants will contact you shortly to assist with your query.

With Care
Team Sizwe