SK
Shannon K

1 reviews | Active since Apr 2021

12 Jun 2023, 16:40

Mr Kammies

Why is everything a fight with this medical aid, my daughter was born on the 27 th of April and and had authorization for 3 days, on the 4th day she was discharged and the gynecologist came to 1 to discharge her I waited with my wife for the doctor to discharge her it's not our problem he didn't come early morning and now the hospital islaiming a 4th wiich I Wil not pay we can't just be walking out of a hospital with a newborn without the doctors approval, the baby had a bit of yellow in the eyes and blood was taken in hospital I'm not even sure because sizwe have a neck for not paying bloods even if it is in hospital, now the pediatrician who oversaw my baby in hospital from the time she was born the claim for in hospital is being rejected, then there were 2 follow up after discharge it's so easy to just say funds depleted but my baby was added to the scheme and she was covered from the 1st of April now I want to know does this enablemed love what they are doing or what clearly they are not up to scratch, and I'm gonna say it again no where does it state enablemed is in charge of the maternity benefits other than word of mouth if it's not communicated in writing it's not true, and I am very unhappy with the medical and how they leave patients and customers in a ditch when life is difficult enough poor poor, get rid of this enablemed before they cost you money, this needs to be sorted out, and does not matter if it's a standard option scheme we as the people pay alot of money for it, it sould not get less assistance because it's standard,, and where does it state the scheme uses your yearly specialists visit to fund the maternity benefit because they have used my wife's gynecologist visit up and says now funds depleted and seeing taht the maternity benefit paper shows 6 x gp specialist visit per pregnancy no whee does it states you would have used my wife's benefits but there was noting from the maternity benefit which it shows on the paper I have send to my laywers, because any scheme knows the risk in pregnancies like with us the baby was breech and we had to be monitored with 3 extra gynecologist visits, so if my wife's visit x3 was used up where was the benefits once? And they sould know a women must see a gynecologist after having a baby too, now there is a bill R3200 wich sizwe don't want to pay? Action will be taken now

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply13 Jun 2023, 10:10
Official
Dear Shannon, 

Thank you for the submitted query. Kindly be advised that we are working on your query. 
Feedback will be provided to you as soon as it is available. 

Apologies for the inconvenience caused and thank you for your patience. 

Sizwe Hosmed team.