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.
Child Medical Aid
There are a number of situations where parent consider having their children on a medical aid with no adult main member.
- Divorce. Both parents want to contribute to a separate medical aid for the child or children without either parent being the main member.
- Budget Constraints. Parents may want to keep the medical aid cover for their children but drop their cover in order to afford the monthly premiums. Refer to Medical Aid When Retrenched and Unemployed.
- Special Needs. A parent or child may have special medical needs and would benefit from a more comprehensive plan that is more expensive and the parent cannot afford to transfer the entire family to this plan.
Unfortunately none of these situations will be considered by any medical aid as a special circumstance to allow a child or children to be the sole member(s) of the medical aid.
Deceased Parent : Medical Aid for Minors
A child or children whom were members of a medical aid with the parent/guardian being the main member and suffered the loss of their parent/guardian due to death can remain on the medical aid as the sole members. Many schemes may still list the deceased parent/guardian as the main member but there will be no active benefits for the deceased.
Both open and restricted medical aids will allow the children to remain on the medical aid until they reach the age of 18 years. In some instances, young adults over the age of 18 years can continue to remain on this medical aid if they can prove that they are currently students with a recognised educational institution or have a mental/physical disability. However, this will be reviewed on an annual basis.
This sort of medical aid cover may not be considered for children who have already lost their parents and now wish to join a medical aid. In this instance, the legal guardian or an adult relative will have to join the medical aid as the main member.
Medical Aid Options for Children
There are a number of options where parents can consider placing their child or children on a medical aid cover to which they do not belong to. Many medical aids will allow other adults (grandparents, uncles or aunts) to place children on their medical aid.
In the case of a divorce, parents can agree to place their children on a medical aid where a mutually accepted adult is the main member. Both parents can then contribute their share to the main member. This may not always be the ideal situation but it is a better option than dropping the medical cover for the children.
For children with special needs or budget constraints within the household, one parent or an adult child could switch over to a more comprehensive medical aid and a minor child or sibling can then also be a member of this medical aid. It may still be costly but it is better than paying for two adult members on a higher plan.
Always discuss these options with your medical aid – rather be open and honest or your medical aid could drop the cover later. Some medical aids may allow these options while others have more strict criteria about medical aid cover for minors. Medical aids are constantly changing their policies and offering new plans for special circumstances in order to be more competitive in the market. An accredited medical aid broker will be able to advise you on plans that meet with your requirements.