JM
Justine M

1 reviews | Active since Feb 2025

23 Feb 2025, 08:21

Sizwe Hosmed Medical Aid treated me very bad

In August 2024, I ended up in hospital (cancer patient) due to a liver blockage and needed 4 or 5 emergency life saving procedures. While in hospital, I received news from the hospital that Sizwe stated that they will only be paying for 2 days in hospital (I was already about 16 days in hospital at that stage). Me as patient, while in hospital and already having so much stress and worries about my health and whether I was going to make it out alive, I had to call doctors and send my husband up and down to get motivational letters for my medical aid to cover the hospital costs. After my 3rd or 4th procedure in hospital to insert a stent to try and get my liver unblocked, Doctors determined that I would need a specific permanent stent. This was needed to save my life as my liver was still blocking up, which was life threatening. Doctors arranged the procedure to be done ASAP and hospital tried to get the authorization from Sizwe. The day before the procedure,hospital informed me that they have not received any authorization from Sizwe yet. The procedure is so expensive that I could not afford it... I was stressing out, crying and had no way to go. I have been with Sizwe for about 16yrs and I always told friends that they are the best medical aid, but lying in that hospital bed, with all the additional stress and worries they gave me, I really realised that I was wrong about them. I nevertheless sent my husband to their offices the morning of the emergency procedure, and the lady there was so so helpful and tried to help as far as she could (realy great service from her) but unfortunately Sizwe head office did not give authorization. I had to sign for the costs of the procedure myself, otherwise they would have cancelled it that day, and I don't think I would have been here today to tell you this story if I didn't sign myself taking that responsibility of the costs. After hospitalisation of 21days, doctors were happy with final procedure and I went home. I then started receiving hospital accounts for thousands of rands, which I cannot affort, that Sizwe short paid the doctor and other Institutions. I wrote an email to their complaints department to give them opportunity to rectify the situation, did not get response..then wrote follow up email 2 months later..did not hear a word back.. I wonder if they truly care about me as member if they treat me like this?? Till today I sit with accounts, which is going to be handed over due to Sizwe not caring! (I am on a plan which covers 100% hospital costs and some things fall under oncology). Writing this review today as I had no joice as to tell people how I was treated by my medical aid..

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Replies (1)
Sizwe Hosmed Medical Scheme
Sizwe Hosmed Medical Scheme's reply23 Feb 2025, 19:12
Official
Dear Justine,

Thank you for submitting your query, and apologies for the inconvenience caused. 
Thank you for providing the reference number of the query. We will investigate and escalate the query for urgent attention. 

We appreciate your patience. 

Sizwe Hosmed team