Claims Payments
Member care remains my top priority. As can be expected during any management transition, we encountered some challenges in the first week of curatorship, which resulted in the payment of member claims. We sincerely apologise for the inconvenience and thank you for your patience.
The challenges that led to these delays have now been resolved. Claims have been processed, and we are back on track to ensure that future claims are settled promptly and reliably.
Access to care
To ensure continuity of care, we are actively engaging with various healthcare providers on an ongoing basis to prevent upfront payments and ensure that our members continue to receive necessary healthcare services with dignity and without disruption.
NHN, Netcare, Melomed, Clinix and Lenmed (Kathu, La Verne, Lenasia & Randfontein)
JMH (Isipingo & City Hospital) are some of the hospitals servicing Sizwe Hosmed members. Unfortunately, Mediclinic and Life hospitals are not currently servicing our members.
Rest assured that we continue to negotiate with them.
For medication, members can visit our partner pharmacies – Clicks, Dischem and Medirite to receive medication without being asked to pay upfront. Members can also visit independent community pharmacies.
The majority of GPs and Specialists are accepting Sizwe Hosmed members. When members encounter challenges, these are addressed on a case-by-case basis.
Our team is on standby to respond to member queries.
- Normal Operating Hours – 0860 100 871
- After Hours (from 5 pm to 8 am) – 011 353 0109
Special General Meeting (SGM)
I would also like to extend my sincere gratitude to all members who attended the recent Special General Meeting on September 27, 2025. Your participation and input are essential in shaping the future of the Scheme.
A question-and-answer document is being compiled and will be uploaded to the website once it is complete.
Benefit Launch
In line with our commitment to enhancing value for you, we are pleased to have launched our new benefits for 2026. These enhancements reflect our ongoing efforts to ensure that Sizwe Hosmed remains not only a reliable healthcare partner but also one of the most comprehensive and affordable schemes in the market.
New Contributions
Your contributions make it possible for the Scheme to secure access to quality care across our provider network, fund benefits that meet changing health needs, allow us to invest in innovative healthcare solutions and safeguard the Scheme’s sustainability for future generations.
To continue offering this level of care in an environment where medical costs continue to rise, a contribution adjustment or increase is necessary, effective November 1, 2025.
The increase reflects our commitment to protecting you and your loved ones. They are necessary to continue our journey of correcting the historical underpricing of our benefits, while ensuring that no further increase will be needed in January 2026.
At the same time, we remain focused on restoring the Scheme’s financial health through the implementation of cost-containment measures and improved operational efficiencies.
2026 Benefit Enhancements
We are committed to giving our members more value and support – even in the new year. In line with this commitment, we are pleased to announce a 5% increase in member benefits effective 1 January 2026. This means you will enjoy enhanced access and greater utilisation across all your benefits — from GP and specialist consultations, chronic treatment and medication to hospitalisation, maternity and wellness services.
These improvements help you and your family get even more from your membership, ensuring you receive the care you need, when you need it. We are proud to continue investing in your health and well-being.
