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Sizwe Hosmed Medical Scheme (commonly referred to as Sizwe Medical Aid) is one of South Africa’s established medical schemes, offering affordable healthcare cover tailored to various life stages and income levels. Whether you need to submit a claim, register for chronic medication, request hospital pre-authorisation, or locate a customer care office, you can reach the scheme through the official contact channels detailed below.

General Customer Care & Enquiries

For general membership support, plan enquiries, benefit checks, and general assistance:

Emergency Medical Assistance

In the event of a life-threatening medical emergency or when requiring emergency ambulance transportation:

Claims Department

When submitting new medical claims or following up on processed refunds:

Important Claim Submission Checklist

When submitting a claim for processing, ensure the document clearly displays:

  1. Principal member’s full name, initials, and medical scheme membership number.
  2. Patient’s name and dependant code as shown on the membership card.
  3. Healthcare provider’s name, contact details, and practice number.
  4. Specific date of service and relevant ICD-10 diagnostic codes.
  5. Itemised tariff codes with charged amounts and proof of payment (if claiming a reimbursement).

Pre-Authorisations & Referrals

Certain treatments, diagnostic scans, and hospital admissions require formal approval from the scheme prior to treatment.

Specialized Care & Managed Healthcare Programmes

Sizwe Hosmed offers dedicated support programmes for managed health conditions and specialized care needs:

Programme / DepartmentDirect TelephoneDirect Email Address
Chronic Disease & Medication086 010 3455[email protected]
Oncology (Cancer) Programme086 010 3454[email protected]
Maternity Care (Bambino)0860 100 871[email protected]
HIV/AIDS Management (WellCare)086 000 0048[email protected]
Wellness & Preventative Care0860 100 871[email protected]

Scheme Administration & Ethics

Regional Customer Walk-In Service Centres

Members and service providers requiring face-to-face assistance can visit any of the following regional walk-in customer centers: