What to know before changing your medical assistance plan

Last updated on June 23, 2021 at 12:42 PM

Whether it is for financial reasons, a change of job, or a change in your medical assistance needs, you may need to change medical assistance. But what happens to you in the meantime?

South Africans were stunned when the husband of radio personality and doctor Dr Sindi Van Zyl shared his family’s recent struggles. Between two medical treatments, the doctor contracted COVID-19 and has been hospitalized since February. Since then, her medical bills have increased to the point that her family can no longer afford to pay.

The countryside #GiftSindiLife, which coincided with the doctor’s birthday, raised R 1.5 million for doctor’s medical bills. Fans and people who knew the doctor via Twitter have been tricked into contributing to his ever-growing medical bills, but many are concerned that people will not be so generous if they find themselves in the same position.

Here’s what you need to know before changing your medical aid.

Medical assistants have a waiting period

Although medical aids are required by the Medical Plans Act To avoid discriminating against members based on their medical history or pre-existing conditions, physician assistants may charge higher premiums and even impose waiting periods of up to 3 months on members to protect both the plan. and members.

During this waiting period, members pay their premiums in full but can only enjoy limited benefits.

What is space coverage?

Space coverage is an important consideration. It covers the shortfall in medical aid that you would normally be responsible for paying in addition to your existing medical aid payments.

While Gap coverage can help you pay for medical bills when your medical assistance is insufficient, Gap coverage only covers procedures, medications, and medical care that are included in your original medical assistance. Thus, medical expenses that are not covered by your medical aid at all will not be covered by your gap coverage.

According to Former mutual, space coverage is only effective for existing medical aid members it will therefore not cover your medical costs while you change your medical aid provider or if you do not have medical help when you need medical assistance.

What happens when you are between two medical treatments?

From the moment you cancel your medical aid until the moment you join a new plan you are not covered by any medical aid and take full responsibility for your medical bills.

According to Medical Plans Act, you cannot claim your previous medical aid, nor the medical aid that you intend to subscribe or have subscribed for for medical expenses which arose before the end of your waiting period.

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