The ljp is calculated according to a fixed formula that has been determined in the Regulations to the Medical Schemes Act. The longer a person waits to join a medical scheme after the age of 30, the higher the late joiner penalty that will be applied by the scheme.
If you have been a member of a registered medical aid scheme, then this will count in your favour. This is referred to as "creditable coverage" in the relevant legislation. Remember that the scheme will require that you provide proof of such prior medical scheme membership.
To calculate the applicable ljp, the following formula can be used :
A = B minus (35 + C).
"A" is the number of years referred to in Column 1 in the table below.
"B" is the current age of the member,
"C" is the number of years that the member was a member of a registered medical aid scheme (but not including the number of years when the member was a member of a medical scheme as a dependant under the age of 21 years)
| Column 1 |
Column 2 |
| The number of years that the applicant was not a member of a registered medical aid scheme after the age of 30. |
Maximum late joiner penalty |
| 1 to 4 years |
Normal monthly contribution multiplied by 1.05 |
| 5 to 14 years |
Normal monthly contribution multiplied by 1.25 |
| 15 to 24 years |
Normal monthly contribution multiplied by 1.50 |
| More than 25 years |
Normal monthly contribution multiplied by 1.75 |
To demonstrate this with an example. :-
· the member is currently 70 years old,
· the member has been an adult member of a previous medical aid scheme for a total of 20 years,
· the normal contribution (before the imposition of the ljp) is R1 200.00 per month.
A = B minus (35 + C)
A = 70 minus (35 + 20)
A = 70 minus 55
A = 15
Now, refer to Column 1 in the table. In this case, the member will therefore have a late joiner penalty of 1.50 times the normal monthly contribution applied to his payment each and every month. The contribution will therefore increase from R1 200 to R1 530 per month.
These calculations can prove to be quite confusing so please give us a call if you need us to explain this in further detail