Parent & Grandparent Dependants on Pensioner Medical Aid
Pensioners are unfortunately faced with some of the toughest circumstances when it comes to medical aid cover. On one hand they have limited finances in their retirement years, and on the other they need more medical care due to chronic conditions that are part and parcel of the senior years. The thought of long lines at a public hospital coupled with all the other nuances that make most people dread public healthcare means that the service of private practitioners and hospitals is the only option. But private healthcare in South Africa is ridiculously expensive and without medical aid it is unaffordable for most people. So what are the options for seniors looking for medical aid, or for children seeking appropriate cover for parents and grandparents?
Choose the right cover for your budget
Cover for Parents and Grandparents
Medical aids in South Africa will allow for children to cover their parents on their medical aid, provided that it can be shown that the parent is a dependant (in the financial sense) on the main member, or spouse dependant. The same applies for grandchildren. It may be a better option for some where employers are subsidising the medical aid contributions and are open to the idea of subsidising parents and grandparents, be it through a company medical aid or other restricted scheme like GEMS for government employees.
However, it is not always the best choice for several reasons. Firstly, older dependants may utilise more day-to-day dependants at the expense of other dependants on the same plan. Naturally seniors will need more medical care. It is not as much of an issue with the chronic benefit or hospital benefits as these are subject to prescribed minimum benefits (PMBs) and a very large annual limit respectively. PMBs are a set of 25 chronic conditions that are considered serious and life-threatening for which medical schemes must cover unlimited throughout the year.
Read more on medical aid dependants over 21 years.
Medical Cover for Pensioners
The other option is for pensioners to get their own medical aid and pay for it themselves. These days there are several cheaper options that are based on the income of a person. It has its restrictions like only allowing members to see certain private practitioners or visit only certain private hospitals within the network, but it still offers private healthcare at a lower price than more expensive plans. One such popular option these days is the Discovery KeyCare series of plans. However, many other schemes have similar plans.
Pensioners need to assess the plan they select very carefully. It is pointless being restricted to a network hospital that is not near to their home. Emergency medical assistance means that a person has to be able to access a facility as fast as possible. The other issue is that the medical aid that pensioners choose has to be affordable in the long term. Simply affording the premium for a few months and then giving up cover is a waste of time and money. Rather take a cheaper plan that can be afforded every month for the long term.
Restrictions, Exclusions and Rates
Pensioner Waiting Periods
There is no specific waiting period on medical aid for a pensioner. There are two types of waiting periods that applies to every new member. First is the general waiting period of 3 months where the medical aid will not pay for any claim. The second is the pre-existing condition waiting period of 12 months where the medical aid will not pay for any claim related to a condition that existed before joining the medical aid. Attempting to deceive the medical aid through non-disclosure of pre-existing conditions can have serious implications.
Late Joiner Penalty
Every person of any age up to 35 years will pay the same monthly contribution for the same plan irrespective of age, health status or lifestyle. Medical aids do not alter contributions based on individual risk profile like a life insurance policy. However, any person starting up on medical aid after the 35 years is subject to a late joiner fee. This is a type of penalty that is added to the monthly medical aid contribution. It varies depending on the age that a person joins the scheme as well as whether they had previous medical aid cover in the past.
Read more on joining a medical aid after 35 years.
Misleading Alternatives
Pensioners, like every South African consumer of any age, need to be aware that there is no alternative to a medical aid. Neither a hospital cash back plan nor a medical insurance plan can match or offer what medical aid covers. These other products definitely have a place in the South African market and can be beneficial cover above and beyond medical aid but pensioners should not be misled in believing that they are getting the same type of cover as that offered by medical schemes.
Gap cover, another handy add-on to medical aid, pays the difference between what the medical scheme pays and what the doctor demands as compensation. It is not an alternative to medical aid. Rather it should be seen as an optional extra to protect against the shortfall in payouts to the doctor, especially these days when some practitioners charge up to 3 times the medical aid rate. Unfortunately gap cover is a short term insurance that usually does not cover seniors over 65 years of age.
please cal me for a qoute for my mom
Good day
I am in search for a beter medical aid for my mother which must include hospital plan.
She is 69 years old.
Can you kindly provide me with a price list of packages available for her.
Kind regards
Hi
Please let me know if you found something, also looking for the same option.
Thank you
I WANT TO COVER COVER MY UNCLE WHO IS 65 YEARS OLD AND IS USING A DIFFERENT SURNAME FROM MINE.
Ek stel belang in n hospitaalplan
Hi ,
I need medical aid cover urgently for my mum and dad.
last week my dad had his leg amputated at a government hospital , and they are giving him the run around.
He can not deal with the long queues , sloppy service etc.
Desperately need medical aid.
Thanks
Hi Randhir. Sorry to hear about your Dad. He can join any open medical scheme provided that he can afford the monthly premiums. However, his current condition relating to his amputation will not be covered as it is considered toa pre-existing condition. It is therefore subject to a 12 month waiting period.
Good day,
I am in search of an affordable medical aid plan for my dad.
Can you please send me a list of the packages you offer and prices?
Thank you.
My parents have been on the SANDF medical aid all their life. I want to put them on a private medical aid. Will they pay late joiner penalties or does the SANDF medical scheme count as being a member of a medical scheme?
Hi
I am looking for a medical plan / hospital plan for my grandmother age 76. If you can give me a call back
Hi
Please can you assist? Need medical for my aunt, she is 67 years of age.
Hi. Married couple, aged 70. Pensioners. Currently been on Discovery Coastal Saver for years plus Zestlife Gap, but just cannot sustain payments. We are desperate for cheaper options, urgent!. Current premium R3200 plus R287 will both increase in Jan. Don’t mind remaining with Discovery, then no waiting periods.
Please advise urgently.
Thank you
Please contact me for medical aid for my dad and grandchild
Hi, I am not on a medical aid and looking for one which I would also like to put on my grandchildren who is 5 days old
Hi,
I need a medical aid for my mom & my mom in-law, they are 82 & 69(respectively).
I already am covered but need one for only the two of then, I’ll take care of the finances.
Please send me a quote, if my request is possible.
Regards,
I am looking for a medical iad for my mother she was born in 1943 and she is a education pensior, the premiurs will be deducted from her salary she is getting on every month
I am looking for a medicalaid for my dad he is now 64 please help me get something needs to have full cover.
I am looking for a hospital plan for my dad.
He is 78 but still in good health
Hi. I’m looking for a plan that will cover myself, my husband, my 10 year old daughter as well as my 66 year old mother. Any suggestions? I have been searching the internet and can not find a lot of information on the subject. Thanks for the info provided on this site.
PS: Which would be less expensive…mom being listed as my dependent or mom joining a scheme on her own? She used to belong to a medical aid but have been off it for some years now.
Good Day my mom is almost 53 and would like to put her on a medical aid
Hi my name is jane i am looking an affordable medical scheme i am 61 please advice
I’m about to go on pension. Kindly send me information regarding medical aid for a pensioner. My pre-existing condition is rheumatoid arthritis.
Good day. Can you please let me know where I can obtain full medical cover for my grandchildren?
Good day, Please contact me I am looking for a hospital cover for my mum, would really appreciate your assistance. Thanks
I am looking for a medical aid / hospital plan for my husband (age 60) and myself (age 59).
I iam looking for a medical aid for my mom age 65
is it possible for the pensioner who is using bonitas to add his child again who os over 21 or add his grandchild
Hi Precious. You will need to discuss this with your medical scheme. If your child is a student at a tertiary institution then he/she may still be covered up to a certain age.
Good day,
I am looking for a hospital plan cover for my mom, She is 64 years of age.
My gross income is R10,000 pm. Hope you can help
Regards
Hi
I am looking for medial aid for my dad age 63 fairly healthy.
has not been on medical and not yet listed as a dependant of mine.
what would be more reasonable, to put funds in his account and have him join a medical scheme or to add him to my own which I share with my wife, mine is currently subsidised by my employer I am not sure if the same offer applies for dependants.
Regards.