Pick n Pay Medical Aid Contact Details

The Pick n Pay medical aid is the Pick n Pay Medical Scheme, a closed scheme for employees of the group rather than a product open to the public. It publishes a full set of numbers split by function, and using the right one matters because the emergency and managed care lines are answered by different organisations from the client service desk.

Member contacts

• Client Service Department, toll free: 0800 004 389
• General contact: 021 480 4801
• Email: enquiries@pnpms.co.za
• WhatsApp: a chat option is offered on the scheme contact page

Emergency and managed care

• Emergency transportation, run by ER24: 084 124
• Managed care programmes, including pre-authorisation: 0860 767 633

Note the managed care number carefully. It is 0860 767 633. A transposed version of it, 0860 760 633, circulates on third-party sites; the scheme own page gives 767. Save the correct one before you need it.

Employee assistance and fraud

• Employee Assistance Programme: 0800 229 355 or eap@momentum.co.za
• Fraud reporting: 0800 000 436 or pnpms@tip-offs.com

The fraud line runs through an independent tip-offs service rather than through the scheme, so a report can be made without going through the administrator. The EAP is a counselling and support benefit and is confidential from the employer.

Pre-authorisation is the one that costs money if you skip it

A planned hospital admission, a scan such as an MRI or CT, and most specialised procedures need authorisation before they happen. Phone 0860 767 633 with the procedure code from your doctor, the hospital or practice name and the date, and write down the authorisation number. Schemes commonly reduce or refuse payment on an unauthorised admission, and that shortfall lands on you. An emergency admission is authorised afterwards, but the scheme still has to be told, usually within a set number of working days.

What to have ready when you call

• Your membership number and the dependant code of the person the query concerns
• For a claim query, the practice number of the provider and the date of service
• For a benefit query, the option you are on, since limits differ by option

If a claim or a decision is disputed

• Raise it with client service on 0800 004 389 or enquiries@pnpms.co.za and ask for a written outcome
• Escalate internally through the scheme dispute process before going further
• The Council for Medical Schemes is the statutory regulator and takes complaints against medical schemes directly