How to Change Medical Schemes

It is every South African consumer’s right to change service providers when they feel they are paying too much, that they are not receiving the benefits promised to them, or if they are unhappy with the service provided. This holds true for every type of service ranging from cell phone service providers to medical schemes. Many people contemplate changing their medical schemes when they experience a bad experience with medical aid claims. You are within your rights to change at any time.

Points to consider before making a change

Changing between medical schemes is a big decision, and there are a number of factors that should be considered carefully before taking such a step. Follow the rules on how to change medical schemes:

• If you want to make a change because a rival company offers more benefits or a better rate, it may be best to first contact your present scheme and to ask them if they can match the offer. It is also vital to remember that the competition between the schemes is fierce and that extravagant promises do not always translate into real savings or better service. The new scheme may charge a joining fee that will negate the savings achieved.
• If a change is contemplated because of unhappiness with the benefits received, it is often possible to simply upgrade to a different plan.
• If poor service is the impetus behind a desire to change it is vital to first communicate with the scheme. Most medical schemes pride themselves upon their service excellence and they will do everything within their power to solve client complaints.
• Change to a new scheme may have serious implications regarding cover. Most schemes have a waiting period before the cover becomes available. The waiting period may be up to ninety days, and in that period no cover will be available. There is generally also a condition-specific waiting period on top of the general waiting period when you change. A waiting period of up to a year can be imposed upon some pre-existing conditions. The purpose of these waiting periods is to discourage consumers from joining a scheme only when they fall ill.

Points to consider if you still want to change medical schemes

If, despite the potential drawbacks listed above, you still decide to change medical schemes, here is what you must do:

• Find a plan at another medical scheme that better suits your needs and your budget. It is sometimes very difficult to compare the various plans on offer and it may be best to ask advice from a medical aid broker that is independent and that does not work for any specific scheme. The internet can also be used to obtain several quotations for comparison purposes.
• The next step is to apply for membership at the new scheme. As part of the registration process, you may be required to provide full details regarding your current plan and medical scheme. It is vital to wait until the new scheme confirms that you have been accepted as a member.
• Once you have received confirmation from the new scheme, you have to notify your old scheme, in writing, that you wish to cancel your membership at their scheme. The old scheme should issue a certificate with details of the previous cover.
• The new plan cannot come into force until the old plan is terminated because it is illegal to belong to more than one scheme at a time. It is, therefore, important to manage the dates of termination and activation carefully. If this proves impossible, it may be a good idea to obtain interim cover by purchasing health insurance for a specified period only.

How to Change Medical Schemes is an article copyrighted by © Medical Aid Plan