Medical Aid Premium Waiver Cover Pays When You Can Not

No breadwinner wants to imagine what would happen to their family’s medical aid cover should they be unable to pay the premiums. However, it is a reality that medical aid falls away when the main member, who is usually the breadwinner, dies or becomes disabled. Without a stable income, it is difficult to pay for the ever increasing costs of having medical aid in South Africa.

Your scheme may understand your plight for a month or so but ultimately non-payment of your monthly contributions means no more cover. Fortunately there are insurance products in place that have catered for these possibilities. The medical aid premium waiver cover can protect you for up to 24 months by paying your monthly contributions for you and your family.

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Age Limit for Children and the Elderly on Medical Aid

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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Diabetes Benefits on Medical Aid

Diabetes mellitus, commonly referred to as sugar diabetes, is a growing problem in South Africa. It requires proper medical treatment and lifelong management and without medical aid, diabetic care at government hospitals and clinics would be the only option. Diabetes management is expensive as it requires constant medication, monitoring and pricey procedures like dialysis once complications arise. Medical aid fortunately makes diabetic care in the private health sector affordable.

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Medical Aid Gap Cover vs Hospital Cash Plan

Although they are two different financial products, there is still much confusion about medical aid gap cover and a hospital cash plan. Both provide financial protection in terms of medical bills but in different ways. Ideally you should have both types of cover if you can afford it, as well as medical aid, but none of these products can replace another. Here are the three ways that these different financial products protect you :

  1. Medical aid protects you against the high costs of private healthcare in South Africa.
  2. Gap cover protects you against the shortfalls from what your medical aid pays and what your doctor charges.
  3. Hospital cash plans protect you against the financial loss of being hospitalised.

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Quotes for Medical Aids in South Africa

So you have decided to join a medical aid and it is time to shop around for quotes. Fortunately getting medical aid quotes has never been easier. In the electronic age it is simply a matter of a few clicks and you can have scores of quotes for medical aids at your disposal. Or simply fill out an online form and have brokers calling and emailing you with the best products in the market. However, there are several points that you should be aware of if you want an accurate medical aid quote and a true idea of how cover will affect your budget.

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Medical Aid Exclusions for Pre-Existing Conditions

All medical aids in South Africa have a rule – no person can be refused membership based on their age or health status but pre-existing conditions can be excluded from cover for the first 12 months. It is one way in which medical aids can ensure that new members do not join the scheme and drain the pool of funds contributed by the existing members over time. It is not discriminatory as some people may feel. It does not matter whether you are pregnant, have diabetes or are HIV-positive. It is just an across the board rule to ensure that only people who are contributing to a scheme as a loyal member have access to the full range of benefits. Any person can become a member of the medical aid and therefore any person can enjoy these benefits.

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Medical Aid for Pregnant Women in South Africa

Medical aids is South Africa have very strict criteria about cover for new members with pre-existing conditions. This is not only about diseases but any medical condition that exists at the time you sign up for membership. Pregnancy is one of those conditions. However, pregnant women should still join a medical aid since the cover may still be necessary for the newborn baby as well as the mother’s other medical expenses.

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Medical Aid Benefits for the Year

Depending on the type of plan you signed up for, there are three sets of medical aid benefits available for the year. It is important for members to understand what these benefits mean and how it impacts on their healthcare needs. These days medical aids are becoming much more restrictive with managed healthcare to control spending. It therefore requires careful planning and participation by the member to ensure that the benefits last the entire year or at least most of the year. Realistically the medical aid benefits on most plans can fund the average person’s healthcare for most of the year but given the overuse of medical aid, fraudulent claims, unhealthy lifestyle and diseases like HIV which makes a person ill more frequently, the limits for these benefits are often not enough.

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