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.
Non-payment of Medical Aid Premiums
Medical aid premiums are paid monthly. This means that you are covered for medical expenses up to certain annual limits for the year for any essential and legitimate healthcare services. If you do not pay your medical aid premium for the month then your membership is temporarily suspended. It is a temporary measure where the medical aid will not pay for any health bills until you remedy the situation and pay what is outstanding in terms of your premiums. Medical aid do not accept any excuses for non-payment and you are at risk of having no financial protection for health costs should you fall ill.
If you pay back the premiums that you owe, the suspension is lifted. Any health bills that you accrued during your suspension will be paid to the doctor, hospital or other service provider as long as you still have sufficient benefits available. But if you continue to not pay your premiums, usually for 3 consecutive months, then the medical aid can terminate your membership entirely. You will then need to rejoin a medical aid, either your current scheme or a new schemes. You will have no cover from the time of the suspension and throughout your termination until you join a new medical scheme.
Death and Disability of Main Member
Losing a member of the family is a tragic event that we all face at some point in life. But death has profound implications if the breadwinner in the family dies. In terms of your medical aid cover, should the member be the person who passes on then there is also the complications of who will be paying for the monthly medical aid premiums. The entire family is at risk as medical aid cover can fall away leaving members exposed to sky high private healthcare costs or government clinics and hospitals. Nobody would want to face these circumstances and it is therefore important to take the necessary measures to protect you and your family.
Even if you have life insurance cover and your family will be taken care of financially, the payout is usually not immediate. You will have to wait for a month or two at least before the paperwork is complete and you are paid out. Remember that this money may have to last you for a very long time. It may also have to pay for any outstanding debts that the deceased may have accrued in their life. Before other adults in the family find a job and establish another source of income, can they really afford to keep paying for medical aid membership. Consider all the monthly expenses they will face in life? Premium waiver protects you in the event of death and some policies also consider permanent disability.
How does premium waiver work?
Premium waiver is simply an insurance policy that pays for the medical aid premiums upon death of the main member. While you medical aid may have some sort of protection to waive one or two months of premiums after death of the member, premium waiver will cover you for up to 24 months. Your medical aid is not obliged to give you free cover after death of the main member. Neither can they give you an indefinite leeway. You will need to keep paying the medical aid premiums for continued cover. This means forking out thousands every month to keep the cover going. Premium waiver offers some solace in this regard and should be considered as much of a necessity as medical aid gap cover these days.
Premium waiver starts from around R100 per month and the cover will pay up to a maximum of R4,000 per month for your medical aid premiums. The payout is directly to the medical aid for the 24 month period. It covers death and in most cases also permanent disability of the main member. Premium waiver cover may only be applicable for main members younger than 60 years of age. Pre-existing diseases may affect the outcome of the application.