Joining a Medical Aid After Falling Pregnant
Medical aids usually do not cover any procedure or treatment for a pre-existing condition within the first year of joining a scheme. This applies to pregnancy as well and almost all medical aid schemes will not cover the pregnancy and delivery costs for a new member who joins the scheme when pregnant.
The list of registered South African medical aids was sourced from the Councils of Medical Schemes website. Some of these medical aids may have discontinued business or changed their contact details. This list serves as a guide and Vitacare Health will not be held liable for any incorrect information. Always refer to the medical aid’s website or phone the call centre for more information. New medical aids may not be listed here.
A restricted medical aid means that only employees of a certain company or workers of a specific sector of industry can join the medical scheme. It is not open to the general public. Always refer to the contact numbers on your latest medical aid card for the most up to date details. Your medical aid may have different contact numbers for general enquiries, hospital authorisation and emergency services.
Private medical aid is not compulsory for South Africans but is often considered as a necessity by most given the overburdened public health system. Medical aid is a form of insurance that differs from medical insurance and national health insurance. The latter, national health insurance, is not as yet available in South Africa (2011). However, it has been planned for the near future and this will most likely be necessary for all South Africans irrespective of whether they have private medical aid or not. For now, and for most of the foreseeable future, medical aid will be the tool to access quality healthcare without the restrictions that befall many who opt for public healthcare.
Medical aids in South Africa do not accept a child or children under the age of 18 years to be the only members on the scheme without an adult member (main member). There are certain special circumstances where this will be allowed but it should be discussed with the individual medical scheme or an accredited medical aid broker. The exception to this rule is if a parent or guardian who was previously the main member is now deceased but there are financial resources to keep the medical aid membership going for the children. In this instance, minors will be the sole members on the medical aid.
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Facing the prospect of retrenchment can be quite taxing on any person and one has to consider a host of financial hardships that will inevitably arise due to the lack of employment. Most people choose to trim unnecessary expenses and insurance cover as well as medical aid is often stopped in order to stretch the monthly budget.
However, the cost of private healthcare in South Africa means that you will be financially strained should you not have medical aid cover nor the cash to pay for your medical bills. So what should you do about medical aid cover if you are employed or soon to be retrenched?
Medical aid cover is open to a person who has been diagnosed as HIV positive and in most instances, there is no additional cost for the benefits. Most medical aids in South Africa do have strict exclusion policies where any pre-existing chronic condition will not be covered in the first year of joining the medical aid – the same may apply for HIV/AIDS. However, after this exclusion period, you will enjoy the full benefits of medical aid cover with special programs for HIV/AIDS patients ensuring that you get the best care.
