Insurance & Medical Aid · Support
Sizwe Hosmed Claims Contact Details
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Send new Sizwe Hosmed claims to claims@sizwehosmed.co.za, and call Customer Service on 0860 100 871 or email queries@sizwehosmed.co.za to follow up on a claim. Sizwe Hosmed Medical Scheme was formed when the Sizwe and Hosmed schemes merged, and this page covers its claims route only.
For membership, chronic and other scheme contacts, see the main Sizwe Hosmed contact details page.
Sizwe Hosmed claims contact details at a glance
| Route | Details |
|---|---|
| New claims (email) | claims@sizwehosmed.co.za |
| Follow-up claims (email) | queries@sizwehosmed.co.za |
| Customer Service | 0860 100 871 |
| Pre-authorisation (email) | authorisations@sizwehosmed.co.za |
| Pre-authorisation (phone to confirm) | 086 010 1176 |
| GP to specialist referral (email) | primary.referrals@sizwehosmed.co.za |
| Complaints (email) | PO@sizwe-hosmed.co.za |
| Whistleblower line (fraud) | 0800 212 150 |
| Whistleblower email | sizwehosmed@whistleblowing.co.za |
| Member app | Sizwe Hosmed Medical Scheme App (Google Play and App Store) |
Official Sizwe Hosmed claims route
The scheme splits claims email by stage. A claim you are sending for the first time goes to claims@sizwehosmed.co.za. Questions about a claim already submitted go to queries@sizwehosmed.co.za, which is also the general enquiries mailbox. If you would rather speak to someone, call Customer Service on 0860 100 871.
Members can also download the Sizwe Hosmed Medical Scheme App from Google Play or the App Store. The scheme’s contact page is now at sizwehosmed.co.za/contact/; the older contact-us address no longer works.
What you need before submitting a claim
Sizwe Hosmed says a claim must show:
- The provider’s name and practice number.
- The principal member’s name, initials and medical aid number.
- The date of treatment.
- The patient’s name, plus date of birth and ID number if the patient is not the main member.
- The amount charged, the tariff code and the ICD10 diagnosis code.
Claims must reach the scheme within four months (120 days) of treatment. To avoid a partial payment, get a GP referral before you see a specialist and pre-authorisation before treatment.
Step-by-step claims process
- Before treatment, request pre-authorisation at authorisations@sizwehosmed.co.za, then phone 086 010 1176 to confirm it.
- If you need a specialist, get a GP referral through primary.referrals@sizwehosmed.co.za.
- Submit the claim with all the required details to claims@sizwehosmed.co.za within 120 days of treatment.
- Follow up through queries@sizwehosmed.co.za or Customer Service on 0860 100 871.
A claim can be approved, partially paid or rejected. The scheme lists these rejection reasons: missing documents, late submission, a non-network provider, no pre-authorisation, exceeded or exhausted benefits, and duplicate claims.
Escalation route
If a claim problem is not resolved through Customer Service, email a complaint to PO@sizwe-hosmed.co.za. Note the hyphen in this domain: the scheme prints the complaints mailbox on sizwe-hosmed.co.za, while its other mailboxes use sizwehosmed.co.za. To report suspected fraud, use the whistleblower line on 0800 212 150 (toll-free) or sizwehosmed@whistleblowing.co.za.
For other medical schemes, browse the insurance and medical aid hub or the insurance directory S listings.
Frequently asked questions
What is the Sizwe Hosmed claims email address?
New claims go to claims@sizwehosmed.co.za. Follow-ups on existing claims go to queries@sizwehosmed.co.za.
What is the Sizwe Hosmed claims contact number?
Call Customer Service on 0860 100 871 about a claim.
How long do I have to submit a Sizwe Hosmed claim?
Four months (120 days) from the date of treatment.
Why was my Sizwe Hosmed claim rejected?
Common reasons the scheme gives are missing documents, late submission, a non-network provider, no pre-authorisation, exhausted benefits and duplicates.
How do I get pre-authorisation?
Email authorisations@sizwehosmed.co.za and phone 086 010 1176 to confirm.
Sources
- Sizwe Hosmed, Contact: sizwehosmed.co.za/contact/, read 2026-09-26
- Sizwe Hosmed, Claiming from the scheme: sizwehosmed.co.za/claiming-from-the-scheme/, read 2026-09-26