Medical Aid for Pensioners and Senior Citizens

There is probably no other time in life that one will need medical aid more than in the senior years. As we get older, our body becomes prone to a host of chronic diseases that require ongoing treatment and professional management which can be costly. Apart from diseases, the normal age related changes in the body that can cause discomfort and impairment is distressing without adequate medical care.

Although there is no specific medical aid for pensioners, and any medical aid will accept senior citizens, it is important to know some of the issues that arise with joining a medical aid late in life. It is always advisable that pensioners and senior citizens do not consider giving up the medical aid that they currently have in a bid to search for cheaper cover at a later date. Switching over to another medical aid may be one option but at the end of the day all medical aids are essentially the same.

Costs of Pensioner Medical Aids

Medical aids do not discriminate against any person by changing the price of a plan. Basic monthly contributions are the same for all members on a specific plan irrespective of their age or pre-existing ailments. However, there is a late joiner fee for signing up with any medical aid after the age of 35 years. This fee is ongoing for a person’s life and it is therefore always advisable to join a medical aid earlier in life and stay on it. You will still be held liable for this fee if you leave one medical aid which you had joined prior to 35 years of age, wait for a while and then join another scheme. However, the late joiner fee is not applicable if you switch from one medical aid to another without any gap in between.

Restrictions for Senior Citizens

There is no specific restriction for a senior citizen just based on their age. Various medical aid restrictions, also termed as exclusions, apply to every new member irrespective of their age. However, these restrictions may not be as much of a consideration for a younger person as it is for the senior. It mainly applies to pre-existing diseases and related services and medication. Should you be otherwise healthy at the start of your membership, you need not be too concerned with these restrictions.

Pre-Existing Condition Exclusion

Any person who has a pre-existing disease will not be covered for medical costs pertaining to that disease for the first year of membership. This restriction is does not pertain to a person switching from one medical aid to another. It is only applicable to a person starting up anew on medical aid without previous membership. For example, a person with rheumatoid arthritis who then signs up for medical aid will not be able to qualify for medical aid cover for their arthritis bills for the first year.

General Waiting Period

There is also a general waiting period of 3 months that is applicable to every new medical aid member. Once again this is not applicable to a person switching between medical aids but only for a person who is starting up on medical aid without prior cover. In this 3 month waiting period, the medical aid will not cover any medical costs even though you will have to pay for the monthly contributions. Medical emergencies may still be covered as is the case of a motor vehicle accident but this is also dependent on the scheme itself and the situation.

Caution for Pensioners Looking for Medical Aid

Pensioners have to be cautious when it comes to the cost of their medical needs. Medical aid is often essential as most people in South Africa cannot afford private health care without medical aid cover. Pensioners often have limited resources and are even more at a disadvantage. Furthermore the senior years are when you are more likely to fall ill and need medical care. Without medical aid, your quality of life can be severely compromised as you struggle to afford the bills. All South Africans including pensioners can access government facilities but with the state of public health care in South Africa, very few will do so willingly.

If you are a pensioner without medical aid but can afford cheap cover, it is best to sign up for membership immediately. Waiting any longer may mean that you will not be covered for expenses that may arise within the 3 month general waiting period or the one year exclusion period should you have a pre-existing medical condition. The fact of the matter is that no medical aid in South Africa offers significantly more or less medical benefits than another scheme for similarly priced plans. So do not wait for cheap medical aid cover since it is all essentially the same. If cheap medical aid existed that outdid other schemes, then most medical aid members would be flocking to it.