Sizwe Hosmed Medical Scheme

In 2023 is saw a Rheumatologist and paid R2000 cash. I sent in my receipt to claim back my money the day after my visit 30 November 2023 and by January still didn't get any thing after a phone call only a week later I got a lousy I think not even R800 back. That smell month I paid cash for my medication R1300. And with all of this I still paid my medical aid in full.

So last year my daughter had to see an Orthopedic surgeon. The visit was on the 13 of November 2024 R830 cash. I sent through the invoice and receipt to their claims department once again. A week later a lady who's name is have said that she I will escalate the payment. She said that they only have 1 payment run a week. We are now at the 9 of January 2025 and low and behold still haven't received a dime. The gentleman I spoke to now said that they are waiting for the receipt and invoice from the doctor which I sent because I received a automatic reference number via email confirming that my email was received. I just don't understand why we pay such a lot of money to the scheme and get such poor service. I missed my appointment today because my optometrist could not confirm benefits according to the lady at Sizwe the system was not updated yet and I am on a savings option. When I called them myself when I got home the lady who's name is have said that the Optical benefits are not covered by the savings and she does not know why she would say that. I spent a total of 21 minutes on the line just today. This is disgraceful and disgusting service from Sizwe Hosmed.

Futhermore I tested positive for Rheumatoid Arthritis 2023. Could not continue with testing and medication because Sizwe does not cover the some medication and can't even refund what I pay cash. This is just sad and imagine how much we pay to stay covered on this medical aid.