Medical Aid F.A.Q.

How do I decide which Medical Aid to join?

We provide you with all the necessary information about the medical aid schemes in South Africa we service. Among them are the leading medical aid schemes in South Africa. By educating you on the various schemes, you will know exactly what you will get.

How do I apply for a Medical Aid Scheme?

When visiting our “Contact Us” page, you will see a “Comparative Quote” link on the left of each medical aid. By clicking on this link you will be sent to a page where you can fill in your details and click on the button below the form. Your details will be sent to a company who will contact you and provide you with 3 to 4 quotes including the specific medical aid you prefer.

What are “day-to-day” benefits?

This type of services is medical services, which a member qualifies for when he/she is not hospitalised. This includes services such as glasses, medications, doctor consultations, etc.

Can a Medical Aid refuse a new member?

No, unless it is a closed schemes. These includes medical aid schemes such as Profmed, which only covers graduated professionals such as lawyers, doctors, etc.

How is a medical aid scheme rated?

A medical aid scheme is rated by Global Credit Rating (GCR), an independent company that rates schemes on their claims paying ability. These companies are then given a rating. These ratings range from BBB-, which is the lowest rating to AA, which is the highest rating.

What Medical Aid Schemes are best in terms of credit rating?

Please see the list below of what the schemes are currently rated as:

Medical Schemes featured: Rating:
Discovery Health AA
FedHealth AA-
Bonitas Medical Aid AA-
Spectramed A+
Liberty Medical Aid A+
Momentum Health A+
Resolution Health Medical Aid A

Can I belong to more than one Medical Aid Scheme?

Unfortunately you are entitled to be a member of only one medical aid scheme.

I want to move to another Medical Aid Scheme. Is that possible?

Yes, it is possible. Please note that all medical aid schemes need to be notified a calendar month in advance.

If I apply for a Medical Aid Scheme option, will I be covered immediately?

Medical aids will impose a 3-month waiting period wherein no claims will be paid out and/or 12-month exclusion for any pre-existing medical condition.

When are someone qualified to be a dependent?

Any person who is financially dependent on the main member can qualify as a member. Please note that children can be dependents of a medical aid scheme up to the age of 21. Some medical aids do cover children to the age of 27, which is financially dependent on the main member.

What is a late joiner penalty?

A late joiner penalty is a penalty that is enforced by medical aid schemes to members that have not been a member of medical scheme for a certain period. This normally applies to those that are 35 years of age and older. Read the “Late-Joiner Penalties” article for more information.

How is a late joiner penalty calculated?

For more details on how a late joiner penalty is calculated, read the“Late-Joiner Penalties” article.

Terms that Medical Schemes Use

Read the article or Terms Medical Aid Uses

 

 

 

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