Sizwe medical aid don't want to pay Ambulance & hospital in 12 months waiting period

Good Day All

Trust this mail finds you well.

Can you please re-visit my child, 12 months waiting period due to a fact that I’m having this Sizwe Medical Aid since 01 June 2020 joining date and my child been during this time more than 3 time admitted in Hospital, as I’m speaking now she’s in Hospital again for Epilepsy and diagnosis with (HIE) part Cerebral Palsy.

1. First of all we have to look at Sizwe Ambulance services, contacting the *** number, ambulance taking 1 hour + for assistants, like yesterday (11 October 2020) I phone twice and then I was told the first call was not register and my child was already having a seizures attack for more than half an hour, then I even turn to our Government service Ambulance for assistants.

2. Due to the Covid 19 and lockdowns, I believe that this Hospital in and out of my child, putting her at high Risk contracting the virus with her know diagnosis.

3. The Medical schemes act 1998, (ACT no.131 of 1998 in respect of my child diagnosis (PMB) we need an immediate cover on private Hospital and private ambulances services without the waiting period applies due the Covid 19 and not putting my childs life in serious jeopardy.

4. My child 4 years and 5 months diagnosis is an emergency medical condition that request immediate medical or hospital treatment, where failure to provide medical or Hospital treatment would result in serious impairment to brain functions or serious dysfunction of bodily and psychological mental health issues.

5. The mental health care act no.17 of 2002 makes provision for a compulsory 72-hour assessment period for an individual with (HIE & EPILAPSY & CEREBRAL PALSY) make it compulsory to presenting my child with psychiatric emergencies, hence the 12 months waiting period is indicated for my child.

6. PMB CODE:902T, PMB cover epilepsy under the diagnosis and treatment pairs; the disorder is also one of the chronic diseases.

7. Can you please re-visit her waiting period because her status EPILEPTICUS / HIE / CEREBRAL PALSY that’s a life-threatening condition defined as generalized convulsions that involves that’s she have a tonic-clonic seizure that last for 30 -45 minutes repeated seizures that need immediate treatment. I need Sizwe medical aid scheme must fund in full the diagnosis and need treatment provided in protocols under PMB, please inform me ASAP because my child are in hospital on this moment.