Joining a medical aid is a simple process. You can either go through an accredited broker who acts as an intermediary between you and the medical aid or you can contact the medical scheme directly and request application forms. Most medical aids now have online platforms where you can enter your details and the scheme will contact you with quotes and email you the application form.
If you are joining a company medical aid, your employer or the human resources department will handle your medical aid application. Alternatively your employer may request an advisor from the medical aid or an accredited broker to assist employees with completing the application form.
Who can join a medical aid?
Any person can join a medical aid irrespective of their age or health. This includes people with pre-existing medical conditions but the medical aid may impose a 1 year waiting period before paying for claims related to this condition. If you are over 35 years of age, you will be held liable for a late joiner penalty which is added to the monthly contributions. Nobody is refused membership on a medical aid as long as they can afford the cover.
Medical Aid Application Forms
Once you receive the application forms, the process of filling it out is quite simple. If you are uncertain about any question or field on the form, it is best to call the medical aid directly and discuss it with them. There is no fee required for applying although some brokers will charge the medical aid a small fee for helping you fill out the form.
Make sure that you clearly state the number of dependents and the type of plan you wish to join as this can affect the final quote. It is also important to be honest about pre-existing conditions. Attempting to deceive the medical aid by not disclosing your pre-existing conditions can work against you.
In the event that you fall ill and the medical aid is able to verify that you had not been honest about your pre-existing condition, the scheme could refuse to pay for medical costs related to these claims. In this instance you would be responsible for all the medical costs incurred and this could be exorbitant.
When will the medical aid cover become effective?
Many medical aids impose a 3 month waiting period before paying for any medical costs. This ensures that new members do not join a medical aid only to use the benefit and leave the scheme. For pre-existing conditions, you may have to wait for up to 1 year before the medical aid will pay for any costs incurred in terms of these ailments.
Bearing this in mind, it is therefore advisable to join a medical aid while you are young and healthy. Waiting till you get older could mean a late joiner penalty and you cannot get immediate cover for most conditions if you wait till you fall ill.
When do you pay your first medical aid premium?
Depending on the date that you have selected for your debit orders to be processed, your medical aid will deduct the contribution on the next month. For the first premium, this may include the pro rata rate for the days covered in the preceding month although most schemes start cover at the beginning of a new month. This will be clearly stated as the date from which the benefit will become effective. In this case, it does not mean that your medical aid will pay for claims prior to the benefit date even if you have been approved.