Premium Waiver for Medical Aid Cover

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Medical aid does not end when the main member dies if there are other dependents on the cover. Death is an inevitability and schemes cannot instantly terminate the membership of living dependents but this does not mean that the dependents are not liable for the monthly premiums. If the premiums are not paid, the existing members on the medical aid cover are initially suspended and continued non-payment will then result in termination.

But what do you do if the main member is also the breadwinner in the family? How will you afford the cost of medical aid premiums? Fortunately there is an additional form of protection known as the premium waiver. Some schemes will automatically grant a waiver for a month or two, but premium waiver should be purchased as a standalone policy if you want relief for as much as 2 years from paying medial aid premiums.

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Newborn Baby Cover on Medical Aid

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Having cover for you entire family should be considered a necessity but when you have a newborn baby, adequate medical aid cover should be one of your primary concerns. The fact is that newborn babies are at the most delicate stage of their lives and need quality medical care. Unfortunately in South Africa, the best medical care is often within the private health sector but these services are expensive. Should your baby be born premature, have some congenital ailment or just needs to spend a day or two in hospital for jaundice, the fact is that these services are not cheap in private hospitals. Even out-of-hospital care for your newborn baby can be expensive with some paediatricians charging as much as R700 or more per consultation. Then there are all the other doctors, therapists, tests and medication. Newborn baby medical aid cover has to be adequate or you will quickly find yourself in heavy debt.

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Affordable Medical Aid for Families

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Finding an affordable medical aid is no easy task. The right medical aid is a matter of both price and benefits. There is no single scheme that can claim to be the best medical aid in South Africa. Each has different plans with different benefits at different prices. There is no denying that medical aid is expensive but it is often a necessity that one cannot do without, especially if you have a family.

Consider the cost of private health services – it is expensive for just one person. Now consider the cost for your entire family to see private doctors and be admitted to a private hospital. An affordable medical aid for families depends on what fits in easily into your budget but at the same time it has to adequately cover your family members with benefits that they need.

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How Does Retirement Affect Your Medical Aid?

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If you are approaching 65 years and worried about how retirement will affect your medical aid, you need not be too concerned because medical aids are not like other financial products such as life insurance or hospital cash back plans. Your medical aid cover is not going to be reassessed, your monthly premiums will not increase and your cover will not fall away simply because you are now a senior citizen. However, there are other concerns about how retirement affects your medical aid if you are on a company medical aid or if you are looking for a medical aid for pensioners without previously having cover. Of course there is the money concerns in retirement and to some medical aid seems like an unnecessary frill but really speaking, it is an essential cover for older people.

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Medical Aid for Children and Babies Only

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Medical aids have a rule that the main member has to be over 18 years old since any younger person is a child and therefore a dependent. Not to confuse the issue though, a child of the main member that is older than 18 years and up to 26 years can also be considered a dependent if they are studying and are supported by the main member. A medical aid for children only can prove to be a major problem especially when there is divorce, remarriage or death of the parents with a guardian taking responsibility for the minor(s). Whether it is a full (comprehensive) medical aid or a medical aid hospital plan only, a child or children need to be under a main member who is 18 years and older. A person’s health status or employment does not matter. It’s a matter of the age of the main member.

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Medical Aid Options and Plans

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It is important to know what you are buying when you sign up for medical aid. There are different options to suit individual or family needs. These options vary according to medical aid plans and every scheme has several plans to choose from. It is not just about price. It is also about benefits and this is where many South Africans fall short. They choose different medical aid options based on the monthly contributions without looking at the benefits of each plan. The pinch is felt when you need certain benefits which is not included on your plan and have to fork out cash for the medical bills.

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Medical Aid for Professionals and University Graduates

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There are broadly two types of medical aids – open and restricted. The latter, restricted medical aids, cater for only specific groups, be it the employees of certain companies, industry workers or those belong to specific organisations. One type of restricted medical aid is that for professionals. This refers to technikon (technical university) and university graduates who have completed a degree encompassing at least 4 years of study. There are several benefits to joining a medical aid for professionals as they are restricted schemes with a very exclusive member base.

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Gap Cover for Medical Aid

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Gap cover is not unique to financial products. For years there has been this additional protection to cover you for any shortfall where insurance does not pay the full amount. Now there is medical aid gap cover as well for when you scheme does not pay the full bill. In this day and age when South African practitioners, especially medical specialists, charge above the NHRPL rate, gap cover can make that difference in affording the high quality of private healthcare that you want. Without it, you will have to fork out cash from your pocket to pay the shortfall that your medical aid does not cover.

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Alcohol and Drug Rehabilitation Benefit on Medical Aid

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Substance abuse is a problem worldwide and South Africans are not immune to this epidemic. Misuse and abuse of alcohol, prescription medication and illicit substances (street drugs) is a reality for every South African, irrespective of race, educational level or socioeconomic status. Often alcohol and drug rehabilitation is a necessity but it does not come cheap. State facilities are overburdened and semi-private or private rehabilitation can be very costly. Fortunately most medical aids in South Africa have a separate benefit for alcohol and drug rehabilitation undertaken by registered practitioners, counsellors and facilities.

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Claiming Back from your Medical Aid

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These days, many doctors and other healthcare providers are contracted out of medical aid. This simply means that the service provider will not accept medical aid payments and you the patient will have to pay for their services from your own pocket. However, as a medical aid member you can recover part of or the entire amount back from your medical aid. The process for claiming back from your medical aid is fairly simple. However, many medical aid members experience difficulties along the line which is more often due to ignorance than ineptitude on behalf of medical scheme workers.

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