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Choosing a Medical Aid in South Africa


 

  

  

How to Join a Medical Aid

On many of the medical aid schemes websites in the frequently asked question one of the first topics you will find is how to join a medical aid. How to Join a Medical Aid There is a set process involved, though the most difficult part of the process is to find a medical plan that is suited to your needs.

The process:

• Acquire medical aid quotes and pick a plan that suits you.

• Fill out an application form of the medical aid of your choice.

• The scheme may ask for additional information or medical tests. These tests might affect the conditions excluded and the waiting period you receive. The scheme has to pay the costs of these tests.

• You will then receive a counter offer letter from the medical aid that details the premium you have to pay, exclusions, waiting periods, late joiner penalties and the terms and conditions of the scheme. This document is normally valid for 30 days.

• Take your time and study this document, do not accept or sign it if you are not comfortable or disagree with the waiting periods or late joiner penalties.

• If you are comfortable with the document you can sign it and will then be a member of the scheme.

 To get your medical aid plan quote by email Click Here 

Some pointers:

• Always be honest, do not hide any of your current conditions this might ensue longer waiting periods or even penalties.

•Rather just sit out the waiting period, remember there are certain life threatening conditions that are not included in the waiting periods that the medical aid schemes have to pay for in full. These are called prescribed minimum benefits; there are a total of 260 of these conditions listed.

•According to the Medical Schemes Act: Medical schemes operate in an environment of open enrolment, which does not allow medical schemes to refuse membership to any applicant. Meaning a medical aid may not turn you away because of pre-existing conditions.

• Medical aid schemes may not base not premium on your risk, premiums might only be calculated on the plan you choose and the number of dependants.

Things to look out for:

Late joiner penalties:

•The Medical Schemes Act (The rules set for medical aids in South Africa) states that:

 Medical schemes are within their rights to impose late joiner penalty fees on members older than 35 that have never been a dependant on a medical scheme and have never been a dependant of a registered South African medical scheme on or before the 1st April 2001.”

 • These penalties can greatly affect the cost of your medical aid premiums and might just turn an affordable medical aid into a very expensive one.

 Waiting periods and condition specific exclusions:

 • The Medical Schemes Act states that: “Medical Schemes may impose a three month general waiting period and/or 12 month condition-specific waiting periods, due to certain factors.”

• Make sure you understand the terms and conditions regarding this waiting periods, you might get penalised should you not adhere to them.

Your question of how to join a medical aid should be answered now. Remember; be honest about your medical history, honesty will save you money and a lot of grief in the future.   © Medical Aid Plan

 

 To get your medical aid plan quote by email Click Here