How to get medical aid?

Medical aid is the cover offered by medical schemes. It should not be confused with health / medical insurance. Any person can sign up for medical aid cover if they can afford the monthly contributions. Medical schemes cannot refused admission based on age, gender or health status and the cover does not fall away at a specific age. The first step in getting cover is to get multiple quotes for medical aid and comparing the cost and benefits.

Do employers have to provide medical aid?

No, an employer does not have to provide medical aid cover to their staff. It is not mandatory but many employers offer medical aid cover as a perk in the employee's remuneration package. Employers also understand that quality healthcare helps to reduce sick days and long waits for medical care, which affects an employee's ability to be productive. A company medical aid is therefore not a requirement for employers.

Will medical aid cover pregnant women?

Yes, medical schemes will cover pregnant women. However, if the pregnancy is a pre-existing condition then those pregnancy-related costs may not be covered by the scheme. There is no medical aid for pregnant women that will waive this pre-existing condition rule. There is a waiting period for new members and this is typically 12 months. Therefore the current pregnancy may be excluded but future pregnancies will be covered if there is no interruption in cover.

Does medical aid cover senior citizens?

Yes, medical schemes will cover senior citizens irrespective of their age even if they are pensioners. Medical aid cannot discriminate by age and cover does not end at a certain age limit. However, joining a medical aid later in life can be more expensive. Medical schemes apply a later joiner penalty to older new members. Finding suitable medical aid for pensioners should be done with professional advice.

Should you review your medical aid?

Your medical needs may change with time. It is therefore always advisable to speak to a medical aid broker or financial advisor about your medical aid cover and make appropriate changes. You may not have to change medical schemes entirely but simply upgrade or downgrade your plan with your current scheme to ensure that your medical aid benefits for the year meets your needs.

Does medical aid exclude pre-existing conditions?

Medical aid does not exclude pre-existing conditions but there is a waiting period on these conditions for new members. It does not only apply to diseases. Even pregnancy is a pre-existing condition if a woman is pregnant prior to signing up for medical aid. However, after the waiting period has passed then a medical scheme will pay for the treatment and management of the pre-existing condition within the benefits of the plan.