An unpaid medical aid premium at the beginning of the month will mean that your membership is immediately suspended. Remember that medical aid premiums are paid for cover in the month ahead. So a bounced debit order or unpaid premium means that you are not covered from that point onwards. However, this situation can easily be remedied provided that you have available funds to settle the bill.

Procedure To Undo Suspension Due to Unpaid Debit order

We spoke to Discovery Health about the procedure for unpaid debit orders and how to avoid having membership suspended. This is the procedure for 2014, but members should first contact their scheme to verify what needs to be done from their side.

1. Call your medical scheme and inform them about the unpaid debit order if they have not as yet detected it. Do not wait to receive any communication from your scheme about the suspension of your membership, as they may only discover it at a later stage. Get a reference number from the scheme agent for the call.
2. Verify whether the medical scheme wants an EFT for the premium done immediately, will force debit your account in a day or two, or will double debit your bank account at the beginning of the next month. Awaiting for a double debit will still mean that your membership is suspended for the current month. A forced debit order can take a few days, so the EFT option is the best.
3. Discovery Health provides a specific number that has to be used for the EFT payment reference. This number is also known as your account number should you be using a linked beneficiary option on your internet banking. The reference/account number must not be confused with the bank account number of the medical scheme.
4. Upon paying the outstanding premium, the proof of payment should be then emailed or faxed to the medical scheme. Email is a better option as the system will immediately generate another reference number for the email correspondence.
5. Call the medical scheme and provide them with the email correspondence reference number. The agent can then trace the email, view the proof of payment and ensure that your cover is removed off the suspension status to an active status.

Remember that the procedure may vary from one scheme to another so it is always advisable that you speak to your medical aid first to verify the steps involved.

Do Not Wait For The Scheme

Many medical aid members choose to wait till they are notified by the scheme that their membership has been suspended due to an unpaid premium. This can compromise your health cover, at least for the current month. You may need to be admitted into hospital, and the hospital billing department will not be able to get an authorization number from your scheme due to suspended membership. This means you will have to pay cash for the admission, or go to a government hospital.

You will also not be able to purchase medication from a pharmacy, or consult with a doctor on an out-of-hospital basis. While pharmacies may be able to verify your suspended membership and not give you the medicines, a doctor’s billing staff may be unable to do so immediately. Instead they will submit the claim, have it rejected due to your suspended membership and then attempt to collect the debt privately from you, the patient.

These are both inconveniences and expenses that could be avoided by containing our scheme the moment you detect that the debit order for the month’s premium has been unpaid.