No open South African medical scheme can legally refuse you medical aid membership. Closed medical schemes on the other hand, which only exist for employees of certain companies, for example, are not available to other members of the public and so you will be excluded if you’re not an employee.

It’s important to know, however, that medical aid schemes do have the right to charge late joiner penalties or enforce certain waiting periods on new members, which can be up to 12 months for certain pre-existing conditions such as hypertension, asthma or pregnancy. This means that your new medical aid scheme will not pay out any claims that you incur within a certain time period that directly relate to these pre-existing conditions.

What if I’m over a certain age and have never had medical aid?

As mentioned above, many medical aids do charge “late joiner” penalties if you are over a certain age and have never belonged to any medical aid fund, or have had gaps in your previous membership of any medical aid.

What if I have no pre-existing conditions?

Even if you don’t have any pre-existing conditions, medical aid companies can impose a general waiting period of three months on you as a new medical aid member, before paying out any claims.

Why can’t I make a claim as soon as I join a medical aid scheme?

It’s important to remember that a medical scheme does not operate for profit. If all its members only joined in order to immediately make claims, these schemes would not be able to stay  solvent. They would struggle to pay out any of their existing members’ claims – even those who’d been contributing with no claims for years and years.

There are strict rules and regulations governing the industry and Fedhealth always abides by these regulations, which were stipulated in the Medical Schemes Act 131 of 1998. With an average of five days in paying out claims, find out more about what sets us apart.