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Medical Aid waiting periods & late joiner penalties

There are two kinds of waiting periods:

  1. A 3-month general waiting period
  2. A 12-month condition specific waiting period

During this waiting period contributions are paid without the member being entitled to benefits.

What is a late joiner penalty?

It is a “fine” by way of additional contributions, imposed when a person joining a medical scheme are 35 years of age or older and was not a member of one or more medical schemes before 1 April 2001.

This penalty do not expire after a certain period. The purpose is to place the late joiner and the other members who have been contributiong towards a medical scheme from a young age on the same level as they receive the same benefits.

Number of years not on a medical scheme after age 35Maximum Penalty
1- 4 years5% x risk contribution
5- 14 years25% x risk contribution
15- 24years50% x risk contribution
25+ years75% x risk contribution

What to do to remove specific condition waiting periods & late joiner penalties:

Provide all membership certificates of previous cover on a medical scheme stating the start and end date.

For more information contact us