Scores reflect the Overall AI Score for each category
Based on recent customer reviews, Sizwe Hosmed Medical Scheme is described by members as a scheme in crisis. Recurring themes include medical savings refunds outstanding for many months, tax certificates never issued, authorised hospital and oncology claims left unpaid, and providers refusing the scheme outright. Members consistently report unanswered emails, dropped calls and template escalation replies, with several escalating to the Council for Medical Schemes and the Ombudsman.
Top Strengths:
- •Coverage, Benefits & Plan Transparency: A small number of long standing members describe major procedures approved, including a TAVI heart valve implant and multifocal lenses, alongside chronic medication and hospital stays covered before curatorship. This remains the highest scoring theme, though most members now report benefits eroded by provider refusals.
Replied to 97% of negative reviews
Reply time on negative reviews: 93h
TrustIndex
2.1
Ranking
#22
in Medical Aid
Reply Time
96h 55m
NPS Score
-100
Recommended: Unlikely
Replied to 97% of negative reviews
Reply time on negative reviews: 93h
Dec '25 - Nov '26
Frequently Asked Questions About Sizwe Hosmed Medical Scheme
What do customers say about Sizwe Hosmed Medical Scheme?
Based on recent customer reviews, Sizwe Hosmed Medical Scheme is described by members as a scheme in crisis. Recurring themes include medical savings refunds outstanding for many months, tax certificates never issued, authorised hospital and oncology claims left unpaid, and providers refusing the scheme outright. Members consistently report unanswered emails, dropped calls and template escalation replies, with several escalating to the Council for Medical Schemes and the Ombudsman.
What is Sizwe Hosmed Medical Scheme's biggest strength?
Sizwe Hosmed Medical Scheme's biggest strength, according to Hellopeter's AI analysis, is Coverage, Benefits & Plan Transparency. A small number of long standing members describe major procedures approved, including a TAVI heart valve implant and multifocal lenses, alongside chronic medication and hospital stays covered before curatorship. This remains the highest scoring theme, though most members now report benefits eroded by provider refusals.
What are the most common complaints about Sizwe Hosmed Medical Scheme?
The most common complaint about Sizwe Hosmed Medical Scheme, based on Hellopeter's AI analysis of recent customer reviews, is Claims Processing & Authorisation. Authorised hospital, oncology and pathology claims are paid then reversed or left under review for months, leaving members handed over to debt collectors. Rejections are issued without reasons, including emergency caesareans and PMB admissions, and elderly pensioners report being blacklisted for scheme liabilities.
How does Sizwe Hosmed Medical Scheme compare to other Medical Aid companies?
Sizwe Hosmed Medical Scheme scores 0.7 out of 5 on Hellopeter's AI analysis of service quality in Medical Aid, compared to the Medical Aid industry average of 1.8. Their strongest theme is Coverage & Benefits (0.9); their weakest is Communication (0.5). The top AI-rated Medical Aid business on Hellopeter is AGS Health (4.1). How is the AI Score calculated? →
Is Sizwe Hosmed Medical Scheme trustworthy?
Sizwe Hosmed Medical Scheme has a TrustIndex of 2.1 out of 10 on Hellopeter, based on 303 reviews in the last 12 months. They reply to 97% of negative reviews, typically within 93 hours. Hellopeter has tracked Sizwe Hosmed Medical Scheme across 1,605 total reviews. How is the TrustIndex calculated? →
Recent reviews (303)
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 Jan 2018
MEDICLE AID REFUND!
SIZWE MEDICAL AID – WHEN WILL I RECEIVE MY MONEY? It has been 10 months and counting since I cancelled my Sizwe Medical Aid membership, and I am STILL waiting for my medical savings refund. I have made numerous phone calls and sent several emails, yet I have received no proper response, no explanation and, most importantly, no payment. My question is simple: WHEN WILL I RECEIVE THE MONEY THAT IS OWED TO ME? This is money that I paid, money that belongs to me, and I am certainly not talking about R100 here. How is it acceptable for a medical aid scheme to hold onto a member's money for 10 months without providing answers or taking responsibility? The frustration is beyond words. I have been patient, I have followed up repeatedly, and I am tired of being ignored. I want a clear explanation for this delay and, more importantly, a definite date when my outstanding savings will be paid. Enough is enough. I want my money back!
1 reviews | Active since Jan 2018
MEDICLE AID REFUND!
SIZWE MEDICAL AID – WHEN WILL I RECEIVE MY MONEY? It has been 10 months and counting since I cancelled my Sizwe Medical Aid membership, and I am STILL waiting for my medical savings refund. I have made numerous phone calls and sent several emails, yet I have received no proper response, no explanation and, most importantly, no payment. My question is simple: WHEN WILL I RECEIVE THE MONEY THAT IS OWED TO ME? This is money that I paid, money that belongs to me, and I am certainly not talking about R100 here. How is it acceptable for a medical aid scheme to hold onto a member's money for 10 months without providing answers or taking responsibility? The frustration is beyond words. I have been patient, I have followed up repeatedly, and I am tired of being ignored. I want a clear explanation for this delay and, more importantly, a definite date when my outstanding savings will be paid. Enough is enough. I want my money back!
1 reviews | Active since Jan 2026
COMPETENT VERSUS NOT COMPETENT
I am pleased to share the good news that Sizwe Hosmed Medical Scheme have paid my outstanding account in full at a well known Laboratory, after more than a year. Good to know that there are still a few employees at Sizwe Hosmed Medical Fund that has passion for their job and are competent.
1 reviews | Active since Jan 2026
COMPETENT VERSUS NOT COMPETENT
I am pleased to share the good news that Sizwe Hosmed Medical Scheme have paid my outstanding account in full at a well known Laboratory, after more than a year. Good to know that there are still a few employees at Sizwe Hosmed Medical Fund that has passion for their job and are competent.
1 reviews | Active since Oct 2026
Sizwe hosmed refund.
I cancelled their medical aid last year 30 November 2025 till to today and 24 October 2026 I havent gotten my money that was left in my savings, theyve been saying they will pay and the broker said it's not on his hands now, recently I filled forms for refund 2 weeks later nothing has happened.
1 reviews | Active since Oct 2026
Sizwe hosmed refund.
I cancelled their medical aid last year 30 November 2025 till to today and 24 October 2026 I havent gotten my money that was left in my savings, theyve been saying they will pay and the broker said it's not on his hands now, recently I filled forms for refund 2 weeks later nothing has happened.
1 reviews | Active since Mar 2019
Still no MSA refund 16 months after membership ended – and no help
My Sizwe Hosmed membership (Value Platinum) ended in June 2025. I am owed a Medical Savings Account refund, and 16 months later I still haven't been paid. I completed the MSA Refund Form and submitted every document they asked for. I have emailed the savings department more than once. I have never received an amount, a status update or a payment date. When I followed up this month, the reply from Lebogang Mokalake only told me to "see our website" and use the complaint form. She didn't answer a single one of my questions. That is not customer service. Members who are owed their own money deserve a real answer, not a brush-off. I have now escalated to a manager and will be lodging a formal complaint with the Council for Medical Schemes (CMS) if I don't get a proper written response. Has anyone else on the Sizwe Hosmed refund list been paid? Please share your experience below.
1 reviews | Active since Mar 2019
Still no MSA refund 16 months after membership ended – and no help
My Sizwe Hosmed membership (Value Platinum) ended in June 2025. I am owed a Medical Savings Account refund, and 16 months later I still haven't been paid. I completed the MSA Refund Form and submitted every document they asked for. I have emailed the savings department more than once. I have never received an amount, a status update or a payment date. When I followed up this month, the reply from Lebogang Mokalake only told me to "see our website" and use the complaint form. She didn't answer a single one of my questions. That is not customer service. Members who are owed their own money deserve a real answer, not a brush-off. I have now escalated to a manager and will be lodging a formal complaint with the Council for Medical Schemes (CMS) if I don't get a proper written response. Has anyone else on the Sizwe Hosmed refund list been paid? Please share your experience below.
1 reviews | Active since Apr 2009
Pathetic - no response to communication or complaints.
I posted the review below on 12 October. To date, neither I nor the provider in paragraph 1 below received any feedback regarding this claim with reference number ***. I have now also been sent ANOTHER fat account by a different provider pertaining to the same hospital stay mentioned in paragraph 1 below. They say they never received payment from Sizwe Hosmed despite trying to follow up for months. in paragraph 2 below, my request for a call back regarding other options has still not been fulfilled. I received an email regarding the account in paragraph 3 below that I submitted for refund stating benefits exceeded. The claim should have been refunded since it is for a chronic PMB condition registered on a care plan with two consultations allowed per annum. I replied saying the account needs to be re-processed using the relevant information which was all provided in every email but once again, radio silence! *** This is the kind of pathetic service that Sizwe members have become accustomed to. I have been a Sizwe Hosmed member for many years now and the service has gone from bad to worse. This particular complaint is regarding three separate issues: 1. My daughter was hospitalised in May 2026, we obtained authorisation for the hospital stay. We have been receiving calls for shortpaid accounts, the latest being a cardiologist. When I called Sizwe on 5 October to follow up, I was told that the provider must send an email to the authorisations department to add the codes they claimed to the existing hospital authorisation and must then be re-submitted and it will pay out. I asked the provider's accounts department to do that but they said they tried that without success. They say they were told previously that it rejected due to us not being on a plan that covers the codes in hospital which was very surprising to both myself as well as the customer service consultant who assisted me. I called a second time on 6 October and was told the claim must be sent to the case management department to add the codes to the hospital authorisation and re-submitted for payment, again no response has been received. Call *** 2. During my first call on 5 October, I requested information on other Sizwe Hosmed's other options. I was told that a callback had been requested. To date, I have received no call from anyone. 3. I submitted an account for a refund on 6 October, it has not been captured as yet. We pay a packet for medical aid contributions and always end up out of pocket thanks to Sizwe Hosmed. Ref: ***
1 reviews | Active since Apr 2009
Pathetic - no response to communication or complaints.
I posted the review below on 12 October. To date, neither I nor the provider in paragraph 1 below received any feedback regarding this claim with reference number ***. I have now also been sent ANOTHER fat account by a different provider pertaining to the same hospital stay mentioned in paragraph 1 below. They say they never received payment from Sizwe Hosmed despite trying to follow up for months. in paragraph 2 below, my request for a call back regarding other options has still not been fulfilled. I received an email regarding the account in paragraph 3 below that I submitted for refund stating benefits exceeded. The claim should have been refunded since it is for a chronic PMB condition registered on a care plan with two consultations allowed per annum. I replied saying the account needs to be re-processed using the relevant information which was all provided in every email but once again, radio silence! *** This is the kind of pathetic service that Sizwe members have become accustomed to. I have been a Sizwe Hosmed member for many years now and the service has gone from bad to worse. This particular complaint is regarding three separate issues: 1. My daughter was hospitalised in May 2026, we obtained authorisation for the hospital stay. We have been receiving calls for shortpaid accounts, the latest being a cardiologist. When I called Sizwe on 5 October to follow up, I was told that the provider must send an email to the authorisations department to add the codes they claimed to the existing hospital authorisation and must then be re-submitted and it will pay out. I asked the provider's accounts department to do that but they said they tried that without success. They say they were told previously that it rejected due to us not being on a plan that covers the codes in hospital which was very surprising to both myself as well as the customer service consultant who assisted me. I called a second time on 6 October and was told the claim must be sent to the case management department to add the codes to the hospital authorisation and re-submitted for payment, again no response has been received. Call *** 2. During my first call on 5 October, I requested information on other Sizwe Hosmed's other options. I was told that a callback had been requested. To date, I have received no call from anyone. 3. I submitted an account for a refund on 6 October, it has not been captured as yet. We pay a packet for medical aid contributions and always end up out of pocket thanks to Sizwe Hosmed. Ref: ***
1 reviews | Active since Oct 2026
I left the scheme in December 2025, Very Disappointing Customer Service – Sizwe has been extremely disappointing, particularly when dealing
Dishonesty, lack of information, poor service, lies and no interest in resolving
1 reviews | Active since Aug 2023
It was no longer paying for hospitalisations,xrays and bloods,we still left with bills with my fiancee from 2025 that were
We left Sizwe Hosmed this year February cos we were unhappy about it
1 reviews | Active since Aug 2023
It was no longer paying for hospitalisations,xrays and bloods,we still left with bills with my fiancee from 2025 that were
We left Sizwe Hosmed this year February cos we were unhappy about it
1 reviews | Active since Aug 2026
Sizwe hosmed ********** and ********, worst medical aid ever
I'm so disappointed in this medical aid that I went looking for another medical aid and joined fedhealth... Sizwe medical aid, when i called them in the beginning of the year to get am authorization number to see my psychiatrist for the year, I was specifically told that I don't need an authorization number... So they paid out the full year with a 30% co payment... But by August after seeing my psychiatrist, they refused to pay... So when I called them they said I needed auth number... But when i told them they said i didn't they said it was an issue with the codes, so they gave me the correct codes and my doctor amended them... They still refused to pay. Another issue was that i was prescribed an anti psychotic which was not on the formulatary list so there was a 30% co payment... They charged me 70% instead of 30% so the medication is R800 and something and I was paying about R590 every month... For several months.... I expect that they pay my psychiatrist and pay me back in full..
1 reviews | Active since Aug 2026
Sizwe hosmed ********** and ********, worst medical aid ever
I'm so disappointed in this medical aid that I went looking for another medical aid and joined fedhealth... Sizwe medical aid, when i called them in the beginning of the year to get am authorization number to see my psychiatrist for the year, I was specifically told that I don't need an authorization number... So they paid out the full year with a 30% co payment... But by August after seeing my psychiatrist, they refused to pay... So when I called them they said I needed auth number... But when i told them they said i didn't they said it was an issue with the codes, so they gave me the correct codes and my doctor amended them... They still refused to pay. Another issue was that i was prescribed an anti psychotic which was not on the formulatary list so there was a 30% co payment... They charged me 70% instead of 30% so the medication is R800 and something and I was paying about R590 every month... For several months.... I expect that they pay my psychiatrist and pay me back in full..