There is actually no age limit on medical aid. Any person of any age who has the right to live and work in South Africa can sign up for medical aid cover. However, there are some restrictions and penalties depending on when you join a medical aid. Your age is not used in a discriminatory manner to determine your level of cover. In fact medical aids in South African accepts any person for cover irrespective of their age or health status although some exclusions may apply for a specified waiting period.

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Minimum Age Limit for Children

A child from the time of their birth can belong to a medical aid in South Africa. Actually, if the mother of a child is already a medical aid member then the baby is covered immediately at birth. Parents then have the option as to whether to keep the baby on medical aid and pay the appropriate premium or to cancel membership. However, when looking for a medical aid for a newborn baby it is important to remember that there must be a main member, who is at least 18 years of age, already covered on the scheme.

In fact this applies to any child under the age of 18 years old. A medical scheme requires that the main member be at least 18 years or older and then the dependents on the medical aid can join irrespective of their age. A child under 18 years cannot be the main member or only member on a medical aid. This does create some difficulty when parents divorce or die and it is the caregivers wish to have the child covered alone on medical aid.

Maximum Age Limit for the Elderly

Medical aids do not stop any older person, irrespective of their age, from joining a scheme. Pensioners and senior citizens can sign up for medical aid cover at any age. However, medical aids will impose a late joiner fee onto the monthly premium. This fee is a penalty of sorts for joining a scheme later in life and applies to any new member who signs up for cover after the age of 35 years. It does not apply if you are switching from medical scheme to another.

But should you never have had previous medical cover or had cancelled previous cover on one medical aid only to join a scheme later, and you are past 35 years of age, then you will be liable for the late joiner penalty. The elderly can rest assured that medical aids will not price the monthly premiums based on their health status. In fact this applies for any member of a medical aid. However, the scheme can impose waiting periods and exclusions on pre-existing diseases at the time that you sign up for cover.

There is a 3 month general waiting period for any new medical aid member during which the scheme will not cover you for health care costs even though you have to keep paying the premium during this time. After 3 months you are then fully covered. Similarly pre-existing disease is subject to a waiting or exclusion period but for the first 12 months of membership.

Age Limit for Children and the Elderly on Medical Aid

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