CM
Christa M

1 reviews | Active since Jul 2022

03 Jul 2022, 09:36

COVID vaccination & Oncology medicine erroneously paid from day-to-day!!!!!

Giving a 1 rating to Sizwe Hosmed is overwhelmingly generous! I would give a 0 rating if possible. My 82 year old mother went for her Pfizer vaccination for COVID-19 and Sizwe Hosmed paid it from her day-to-day benefits. After repeatedly e-mailing them and phoning them, they insist that they paid from the COVID fund, but they did not! I can do simple maths and from the balances of her medical aid statement (on the front page) I can see that they paid from her day-to-day. No person in SA should pay themselves for the COVID vaccination. My mother is also an oncology patient. Sizwe Hosmed approved her medication under oncology, yet they repeatedly pay for her oncology medication from her day-to-day benefits. I have e-mailed and phoned them with no result. To get hold of Oncology Department is like finding a needle in a haystack. There is no direct line, so customer service transfers you to Wellness Dept and they transfer you to Oncology. If you are "lucky" your call gets dropped or you get told their systems are down. When I finally reached an oncology consultant she was extremely unhelpful. She said the meds HAD BEEN approved by oncology and it was Dis-Chem's error. She told me to go to Dis-Chem and sort it out. Dis-Chem said that the oncologist's script was clear, with ICD10 code C50.9 which is for breast cancer so they don't know why Sizwe is paying it from day-to-day. The pharmacist phoned Sizwe and Sizwe realised the error was on their side. They promised to reverse the erroneous payment from day-to-day and pay it from oncology. They promised from now on the meds would be paid from oncology. Well the reality is that they reversed the meds from day-to-day and paid it AGAIN from day-to-day!!! Mind-boggling how *********** they are! The next month, the meds were AGAIN paid from day-to-day. Sizwe Hosmed seriously needs to train their people! Surely it must be awful working there when members complain to them every day. Equally, for a member it is grossly unfair that we should fight about every claim! My mom is paying a fortune on the Titanium Executive plan and this is the disgusting service she receives! Her blood pressure and my blood pressure sky-rockets every time we receive a medical aid statement because we now it is riddled with mistakes. How does Sizwe Hosmed pass their yearly audits????

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply04 Jul 2022, 08:19
Official
Dear Christa, on behalf of Sizwe Hosmed Medical Scheme, we sincerely apologize for the inconvenience caused. We will be in contact with you to resolve your complaint. Thanks, Sizwe Hosmed team.