Organisation : Sizwe Hosmed
Scheme Name : Sizwe Hosmed Medical Scheme
Country : South Africa
Website : https://www.sizwehosmed.co.za/
What is Sizwe Hosmed Medical Scheme?
Sizwe Medical Fund and Hosmed Medical Scheme brought together Sizwe’s 46 900 membership with Hosmed’s 21 000. Sizwe Hosmed is the eighth largest medical scheme in the country with the fourth-highest solvency ratio of the top 10 largest medical schemes.
Related / Similar Scheme : TFG Medical Aid Scheme (TFGMAS)
The merger is mutually beneficial to both Schemes, where the combined balance sheet and increased membership size can unlock efficiencies and economies of scale to the benefit of all members. These improved metrics are important for the market and brokers, as the Schemes aim to achieve their key objectives of membership growth and retention
How To Apply For Sizwe Hosmed Medical Scheme Membership?
To successfully complete the application form, please ensure that you have the following information:
** Your personal details
** Details of your dependants
** Employment details (including proof of income – i.e. payslip, SARS ITA34)
** Previous and Current medical aid details (if applicable), including membership certification with termination dates – for the main member and dependants
** Broker Details (if applicable)
** Banking Details (For debit order and refunds)
** Copies of (where applicable):Identity documents (i.e. SA ID, Birth Certificates / Passport)
** Marriage certificate / proof of common-law marriage or co-habitation
** Documentary proof in case of adopted/foster children
** Proof of study, or affidavit proving financial dependency, for dependants between 21 and 25
** Proof of pre-existing health conditions
** Dependant/s, or doctor’s letter for mentally or physically disabled children
** Proof of bank account (i.e. cancelled cheque, original bank statement, bank letter)
** Any oustanding documents can be emailed, at a later stage, to onlineapplications@sizwehosmed.co.za, quoting your ID/Passport number in the subject line.
Apply Here : https://www.sizwehosmed.co.za/
How To Access Sizwe Hosmed Medical Scheme Membership Portal?
As a valued member of Sizwe Hosmed, you have access to the member portal which will assist you with information that is unique to your membership.
Click on the link to access the portal : https://online.sizwehosmed.co.za/SizweWeb/Login.jsf?id=M
How To Submit A Claim?
Following a consultation with or treatment by, a provider, your account should reflect if it has been submitted directly to Sizwe. If you are not sure, please enquire with your provider. If the account has not been submitted please follow the procedure below. Be sure to submit your claims correctly in order to avoid any delays in payment. Mail or deliver your account as quickly as possible to your nearest Sizwe branch. See contact details on the back of this booklet.
1. Send only the original account you receive. Do not send statements or duplicate invoices.
2. Some doctors offer a discount if you settle the account immediately. If you have already paid the account, attach your receipt and mark the account “Refund Member”.
3. All accounts must show full details of your membership.
Please check that your account reflects the following:
** Provider’s name and practice number.
** Principal (main) member’s name and initials.
** Principal member’s medical aid number.
** Treatment date.
** Patient’s name (as listed on your membership card). If the patient is not the main member, please list their date of birth and ID number as well.
** Amount charged.
** Tariff code (the doctor will fill in the ICD-10 code).
** Diagnosis made by the doctor or specialist.
As proof that you have received the treatment that is being charged for on the account, please sign the account before submitting it to Sizwe. Claims are paid to providers every week and you will receive a monthly statement that shows all claims received and paid for since the previous statement. Pharmacies can submit claims in real time, on-line. This means that when receiving your medication at the pharmacy, you will know almost immediately whether Sizwe has accepted your claim.
Important:
** Only claims received within four months of date of treatment will be paid.
** Why wait for your refund cheque to be sent to you in the mail? Sizwe can transfer any money owing to you electronically so that it appears directly in your cheque or savings account. To benefit from this Electronic Funds Transfer (EFT) service, please fill in the special EFT form, available at your nearest Sizwe branch or on the website
Contact
Contact Centre – 0860 100 871 or email to queries@sizwehosmed.co.za