Based on recent customer reviews, Netcare Medical Scheme draws sustained criticism over gap cover and claims administration. Members describe claims lost or unacknowledged, documents requested and resubmitted repeatedly, and outcomes promised by end of business but never delivered, with refunds and shortfall payments dragging on for weeks or months. Call centre contact is a recurring pain point, with dropped calls, long waits and consultants unable to resolve queries. Hospital billing disputes, ignored proof of payment and departments working in silos add frustration, although clinical care and one rapid gap payout were praised.
Replied to 100% of negative reviews
Reply time on negative reviews: 144h 22m
TrustIndex
2.8
Ranking
#38
in Health & Medical
Reply Time
131h 49m
NPS Score
-78
Recommended: Unlikely
Replied to 100% of negative reviews
Reply time on negative reviews: 144h 22m
Dec '25 - Nov '26
Frequently Asked Questions About Netcare Medical Scheme
What do customers say about Netcare Medical Scheme?
Based on recent customer reviews, Netcare Medical Scheme draws sustained criticism over gap cover and claims administration. Members describe claims lost or unacknowledged, documents requested and resubmitted repeatedly, and outcomes promised by end of business but never delivered, with refunds and shortfall payments dragging on for weeks or months. Call centre contact is a recurring pain point, with dropped calls, long waits and consultants unable to resolve queries. Hospital billing disputes, ignored proof of payment and departments working in silos add frustration, although clinical care and one rapid gap payout were praised.
Is Netcare Medical Scheme trustworthy?
Netcare Medical Scheme has a TrustIndex of 2.8 out of 10 on Hellopeter, based on 21 reviews in the last 12 months. They reply to 100% of negative reviews, typically within 144 hours 22 min. Hellopeter has tracked Netcare Medical Scheme across 149 total reviews. How is the TrustIndex calculated? →
Recent reviews (21)
Used this business recently? Share your experience to help others decide.
Used this business recently? Share your experience to help others decide.
Share Your Experience1 reviews | Active since Nov 2015
Defnitely not worth the payment
If i could give the medical aid 0 stars i would have,because the exuberant amount we pay monthly vs what they cover is absolutely ridiculous. I have been with netcare for 12 years,so 12 years on the scheme, and ever since discovery took over administration it's been shocking to say the least. Your call center people are wonderful,always helpful and compassionate and try to help,but you escalations?your medical aid case managers? How do you refuse a non dsp waiver for a 4 year old child that needs SPECIALIZED surgery after a DSP messed it up in the first place,would you if you were a parent go back just because the medical aid refuses us to use non dsp hospitals,i understand there is a policy,ive been on this medical aid long enough. But making it sound like i went out of my way to look for a non DSP hospital??because i had to go for a second opinion for surgery that failed my child because the doctors were not competent. We wrote a motivation from doctor,i explained my case i pleaded for help and in 2 hours the answer i get is a dsp doctor at unitas???okay great but i don't know this doctor??I've never heard of her and she has worked at groenkloof under the doctor i found for my daughter,so no i don't find it good enough because we are already traumatized,my child is traumatized so i didn't GO OUT OF my way for a non DSP,i researched because she is 4 and had hip dysplasia thats a complex orthopedic procedure to deal with,you can't just go to any doctor as i can show you and tell you with photos. So as far as I'm concerned I'd rather move to another medical aid who actually has compassion and wants to help than keep paying your ridiculous prices and every year you just lessen the things you pay and limit us on where and when, ***** the motivation or that its specialized,so thank you netcare medical aid for your disappointing lack of concern,empathy or just actually giving a **** in general but hey pay us *** every month and get as little as possible out of it!!
1 reviews | Active since Nov 2015
Defnitely not worth the payment
If i could give the medical aid 0 stars i would have,because the exuberant amount we pay monthly vs what they cover is absolutely ridiculous. I have been with netcare for 12 years,so 12 years on the scheme, and ever since discovery took over administration it's been shocking to say the least. Your call center people are wonderful,always helpful and compassionate and try to help,but you escalations?your medical aid case managers? How do you refuse a non dsp waiver for a 4 year old child that needs SPECIALIZED surgery after a DSP messed it up in the first place,would you if you were a parent go back just because the medical aid refuses us to use non dsp hospitals,i understand there is a policy,ive been on this medical aid long enough. But making it sound like i went out of my way to look for a non DSP hospital??because i had to go for a second opinion for surgery that failed my child because the doctors were not competent. We wrote a motivation from doctor,i explained my case i pleaded for help and in 2 hours the answer i get is a dsp doctor at unitas???okay great but i don't know this doctor??I've never heard of her and she has worked at groenkloof under the doctor i found for my daughter,so no i don't find it good enough because we are already traumatized,my child is traumatized so i didn't GO OUT OF my way for a non DSP,i researched because she is 4 and had hip dysplasia thats a complex orthopedic procedure to deal with,you can't just go to any doctor as i can show you and tell you with photos. So as far as I'm concerned I'd rather move to another medical aid who actually has compassion and wants to help than keep paying your ridiculous prices and every year you just lessen the things you pay and limit us on where and when, ***** the motivation or that its specialized,so thank you netcare medical aid for your disappointing lack of concern,empathy or just actually giving a **** in general but hey pay us *** every month and get as little as possible out of it!!
1 reviews | Active since Jun 2021
Horrible and allows *****
Nectare via discovery processed a claim two years later from my savings now. The service provider does not even answer their phone and I did not receive any services from them. Now my medical aid saving 1k just gone and the agreement two years ago was for that claim to be paid from my apliances benefit. When calling discovery they simply tell me claim is valid and needs to be paid out. This is medical aid *****. I can just go and claim anything on the fund and I font even have to receive a service. I literally got nothing and paid 1k. How fair is this ?
1 reviews | Active since Jun 2021
Horrible and allows *****
Nectare via discovery processed a claim two years later from my savings now. The service provider does not even answer their phone and I did not receive any services from them. Now my medical aid saving 1k just gone and the agreement two years ago was for that claim to be paid from my apliances benefit. When calling discovery they simply tell me claim is valid and needs to be paid out. This is medical aid *****. I can just go and claim anything on the fund and I font even have to receive a service. I literally got nothing and paid 1k. How fair is this ?
1 reviews | Active since Sept 2020
Customer service? What customer service?
Calls not answered, transferal to departments that nobody works at, dropped calls and inefficient and non existent customer service has resulted in many weeks of lack of refund for medication approved and certified for a medical emergency on July 12th 2026. Its now August 18th and still I have promises of payment but nothing received yet. Excellent hospital but absolutely non existent customer service to back it up with.
1 reviews | Active since Sept 2020
Customer service? What customer service?
Calls not answered, transferal to departments that nobody works at, dropped calls and inefficient and non existent customer service has resulted in many weeks of lack of refund for medication approved and certified for a medical emergency on July 12th 2026. Its now August 18th and still I have promises of payment but nothing received yet. Excellent hospital but absolutely non existent customer service to back it up with.
1 reviews | Active since Oct 2022
GAPCOVER - NETCARE PLUS
We have submitted a claim and after 10 working days we had to follow up and they were not even aware of the claim, they then picked it up requested additional documents, which was sent that same day. Followed up several times after that and every time I get promised the outcome will be sent by end of business and then nothing. Then after all this time I receive an email saying they received my claim they will send me the outcome and I am back to square 1 - how difficult can it be to review a claim. They have also since we starting with the gapcover not paid out anything, hence I also cancelled my policy, quick to take your money but they ensure no pay-outs.
1 reviews | Active since Oct 2022
GAPCOVER - NETCARE PLUS
We have submitted a claim and after 10 working days we had to follow up and they were not even aware of the claim, they then picked it up requested additional documents, which was sent that same day. Followed up several times after that and every time I get promised the outcome will be sent by end of business and then nothing. Then after all this time I receive an email saying they received my claim they will send me the outcome and I am back to square 1 - how difficult can it be to review a claim. They have also since we starting with the gapcover not paid out anything, hence I also cancelled my policy, quick to take your money but they ensure no pay-outs.
1 reviews | Active since Feb 2020
Claims are wrong all the time.
I have a huge problem with my medical aid. I visited a specialist recently and the claim was taken from my savings while I have specialist visits available. What’s irritating is that why is this always happening like this? I had a similar problem last year as well. It’s like for me to get proper service I must complain first. Secondly, I had to get X-rays done and there’s a shortfall. Even in 2024 there is a shortfall. Then does this mean every time I need X-rays I must be prepared to pay shortfalls?
1 reviews | Active since Feb 2020
Claims are wrong all the time.
I have a huge problem with my medical aid. I visited a specialist recently and the claim was taken from my savings while I have specialist visits available. What’s irritating is that why is this always happening like this? I had a similar problem last year as well. It’s like for me to get proper service I must complain first. Secondly, I had to get X-rays done and there’s a shortfall. Even in 2024 there is a shortfall. Then does this mean every time I need X-rays I must be prepared to pay shortfalls?
1 reviews | Active since Oct 2014
Maybe change you claim process of 10 days... to 1 MONTH... Pathetic service
Submitted a Claim on the 23 of June wf_*** - I've attached all the documents they asked (Online) Received an Email last Friday that they want the Auth Letter of the Medical aid. I rep**** the Friday and forgot to attach the file. Rep**** monday on the Same email and did Attach the Auth letter from the medical aid. Today they reply that i Did not attached the auth letter but if I page up in the email it is there. How long will this take? as this has been more than 10 days. I also phoned yesterday and the lady on the Phone DID SEE THE AUTH letter... Why can;t the people processing the CLAIM not see the AUTH letter. And why can't the person Handling the claim Send their email direclty to me... as with each response it takes a WEEK AND MORE. This is really PATHETHIC services.... 10 DAYS.... Maybe you must change you Claim processing speed to 1 MONTH!!! And their online system is also not working, I've submitted a claim the day before that and got an email about that, but no WF number... and they can't pick up the claim on the system..its MISSING
1 reviews | Active since Oct 2014
Maybe change you claim process of 10 days... to 1 MONTH... Pathetic service
Submitted a Claim on the 23 of June wf_*** - I've attached all the documents they asked (Online) Received an Email last Friday that they want the Auth Letter of the Medical aid. I rep**** the Friday and forgot to attach the file. Rep**** monday on the Same email and did Attach the Auth letter from the medical aid. Today they reply that i Did not attached the auth letter but if I page up in the email it is there. How long will this take? as this has been more than 10 days. I also phoned yesterday and the lady on the Phone DID SEE THE AUTH letter... Why can;t the people processing the CLAIM not see the AUTH letter. And why can't the person Handling the claim Send their email direclty to me... as with each response it takes a WEEK AND MORE. This is really PATHETHIC services.... 10 DAYS.... Maybe you must change you Claim processing speed to 1 MONTH!!! And their online system is also not working, I've submitted a claim the day before that and got an email about that, but no WF number... and they can't pick up the claim on the system..its MISSING
1 reviews | Active since Mar 2011
Worst Gap Cover- Netcare plus
I have tried almost over a week to get someone at netcare plus gap cover to assist me with my claim, these people go radio silence and make no contact, then they ask you for paper work which was already sent so they delay in making the payment. when will this be resolved, why is it so hard to pick up the phone and communicate, this is very frustrating
1 reviews | Active since Mar 2011
Worst Gap Cover- Netcare plus
I have tried almost over a week to get someone at netcare plus gap cover to assist me with my claim, these people go radio silence and make no contact, then they ask you for paper work which was already sent so they delay in making the payment. when will this be resolved, why is it so hard to pick up the phone and communicate, this is very frustrating