Enablemed POOR SERVICE!

PATHETIC SERVICE! If anyone wants a medical Aid that stresses you out when you already sick, uses up all your airtime, have consultants that have no idea what they are telling you or love being transferred from department to department and NOT FORGETTING being billed unexpectedly when your Medical Aid gave you authorization months back and tells you that are 100% covered in hospital then Sizwe medical aid is for you.

I joined Sizwe Medical Aid with the acknowledgment of it covering 100% in hospital which includes blood tests, normal xrays etc and as well as a capped R6200 limit for out of hospital Radiology and Pathology.

SO HERE is my story....

On the 5 February 2021 i did a CT Scan OUT OF HOSPITAL at the beginning of this year which costed around R3225.91 i ​made sure the Radiology guys contacted Sizwe/Enable meds to get Authorization BEFORE anything was done.

After a 1 hour wait at the Radiology guys Perumal and Partners i finally got an Authorization number to proceed knowing in my mind it was covered i proceeded.

Few days later i had to be admitted IN HOSPITAL which i spent 2 days in and during that 2 days i did some blood tests and also 1 scan IN HOSPITAL which costed R520 this was on the 9 February 2020.

2 months later i get a message via email from the Radiology Perumal and Partners saying i need to pay for my CT scan which was done OUT off hospital for R3225.91 and if its not paid for by the end of the month i will be handed over.

When i contacted Sizwe Medical fund immediately they told me that they deal with IN HOSPITAL issues so i explained to them my issue and all i got was "we deal with IN HOSPITAL matters" aantthe only fter begging for some help they eventually logged my medical Aid number in he system and did only see that whilst IN HOSPITAL i only had done a scan for R520 so i asked them why is my Medical Aid exhausted then? Why was the R3225.91 scan which i had done first not covered for?

"they response was they don't know" and then tranfered me to ENABLE MEDS who deals with the OUT OF HOSPITAL issues.

So i spoke to a consultant from ENABLEMEDS and they response was "you only have R1300 left from your R6200" when i asked them why?

They said its just exhausted and i must contact SIZWE Medical Aid directly to get answers.

So not knowing what to do i emailed Sizwe medical aid again and called them getting pushed back and forth wasting over R500 on Calls being put on hold being shuffled and transferred from department to department.

Now image you being a client lost of what is happening, ill and seeking help from the Medical Provider whom you are paying alot of money to every month consistantly, to just brush you off with a universal response.

Eventually a consultant from enablemed told me that maybe the blood tests i did IN HOSPITAL was taken out from my OUT OF HOSPITAL funds thats why it is exhausted.

When i asked Sizwe Medical Aid if this is true they response was IN HOSPITAL is unlimited and what was told to me is false but it makes no sense.

WHY IS MY MEDICAL AID EXHAUSTED??? When i only used the medical aid 2 times for this year.

I Need a proper answer!