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Thread: Ombudsman contact details

  1. #1

    Ombudsman contact details


    Please send me contact details for the Medical Aid Ombudsman
    What is the process


  2. #2
    Phone: +27 (0)861 123 267
    Fax: +27 (0)12 431 0608
    Email: complaints@medicalschemes.com
    Postal Address: Private Bag X34, Hatfield, 0028, South Africa

    Any beneficiary or any person who is aggrieved with the conduct of a medical scheme can submit a complaint.

    It is however very important to note that a prospective complainant should always first seek to resolve complaints through the complaints mechanisms in place at the respective medical scheme before approaching the Council for assistance.

    Complaints can be submitted by any reasonable means such as a letter, fax, e-mail or in person at the Offices from Mondays to Fridays during 08:00 – 17:00.

    please visit http://doctors-hospitals-medical-cap...ls.php?id=1278 to download a complaint form
    Dr Joy Saville
    BSc (CHS). BCM (UTM) Summa Cum Laude
    Unani-Tibb Medicine

    Always consult your healthcare provider to determine the appropriateness of the information to your own situation.

  3. #3
    Andy van der Helm


    To whom it may concern, (sent Dec 29 and again Jan 17)

    I don't know why I have just received a claim of R56.88 notice from Fedhealth which was at Medirite Brackenfell.

    I paid for this myself after the lady at Medirite noted that I couldn't claim this!!?? I contacted Roweida Januarie at Medirite Brackenfell and she concurred the above payment.

    What shocks me even more she said that the R56.88 is what is claimed from the medical aid!!?? Is this why our medical is so expensive - because service providers are claiming higher amounts from the medical aids.

    From now on I am going to pay cash for my medicine THEN claim from you. IT'S NO WONDER MY SAVINGS IS DEPLETED SO QUICKLY!!!!!!!!!!!!!!!!!

    I am going to the dentist next year : does this mean I must pay cash to the dentist first to avoid a higher claim from my medical aid???

    I would appreciate it if you could answer this query.

    A van der Helm

  4. #4
    Administrator Nanima's Avatar
    Join Date
    May 2012
    Hi Andy, I am not sure who you are sending this message to but if this is for Fedhealth here is their website

  5. #5


    Hi!is it possible that someone who earns on comission can loose her medical aid by not paying a single primum & pay it later.

  6. #6
    Thabo M


    I was suffering a shoulder dislocation and I was then operated.
    The private hospital where I was operated got an authorisation from my medical aid and because of that I was operated on the 22nd January 2016.
    Few weeks later i got messages and calls that my medical aid did not pay all the amount requested by the practitioner.
    I then enquire from polmed why and they said the doctor charged 200% and they only pay 100%.
    My concern is i m now owing the two doctors +/- R9500 of which I do not have.
    If they did explain that they are charging 200% I would have inquire i m going pay from my pocket and I would not have agreed to the operation because I would not afford to pay.
    Any advice?
    Can the two doctors held me responsible for not paying?
    Can I take them to court if they force me to pay because they never explain to me that they are charging more than the scheme rate?
    My email address...tmalatjie66@gmail.com

  7. #7


    Please help me .I have been working as professional nurse since 2014 .After training but my salary is of a enrolled nurse .I Love my job but they are not fair to us.I was even admitted to mental hospital for Depression .

  8. #8



    I recently joined bonitas under bonicap from work. They have a office with a agent on site and he gave me wrong information, after i went there to confirm before application. One of the things he told me was there is no waiting period if you join on your 1 year annivesary meaning when you have been with the company for a year and it will cover my pregnancy straight away. So i joined on mine which is October. I then recieved an sms telling me about 3 months waiting period. I called to confirm and yes there is. I went there to confirm twice before applying, so what should i do?

  9. #9

    One plan pet medical aid scams

    One plan medical aid...
    My pet was rushed to a nearby vet on the 1st and then again on the 2nd and an xray was done..she swallowed a bone...kept her in the vet from the 2nd till the 5th...on that morning took her to for a procedure an endoscopy and the doctor removed it...claim forms was sent over and over but the medical aid came back with excuses and knowing that my pet could not eat and havnt earn since the 1st..she was on a drip..on the 5th from 7am till 1 pm she was off the drip..I told them she needs surgery done..which I was waiting for authorisation..the vet waited for me for the auth..up until today im still waiting for it..had to make a small payment...to save her life..but oneplan doesn't care about animals...it's all a scam...I paid so much and still getting excuses from them...currently pet is still at hospital and I'm waitn for one plan to assess the claim and make payment...but all relevant info and invoices sent and I'm waitn for feedback....they are full of lies....

  10. #10


    Email address of medical ombudsman

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