Bestmed Medical Scheme Late Joiner Fee

  Overall, the Bestmed Medical Scheme is a trustworthy and comprehensive medical aid provider.  New Members 35 years or older may be subject to late-joiner penalties on Bestmed Medical Aid Plans.   The Bestmed Medical Aid Plans start from 1,615 ZAR per month and, Bestmed received the top honours in the Medical Aid Companies category at the latest Ask Afrika Orange Index Awards.    

Bestmed Medical Scheme Late Joiner Fees - 9 Key Point Quick Overview

1. ✅ Bestmed Medical Scheme Late Joiner Fees
2. ✅ Bestmed Medical Scheme Waiting Periods
3. ✅ Bestmed Medical Scheme Exclusions
4. ✅ Bestmed Medical Scheme and Pre-existing Conditions
5. ✅ Late Joiner Fees vs. Waiting Periods: What is the Difference?
6. ✅ What Happens if You Do Not Pay Late Joiner Fees?
7. ✅ National Health Insurance (NHI) Bill South Africa
8. ✅ Our Verdict on Bestmed Medical Scheme Late Joiner Fees
9. ✅ Bestmed Medical Scheme Late Joiner Fees Frequently Asked Questions

Bestmed Medical Scheme Late Joiner Fees

  New members 35 or older may be subject to late-joiner penalties from Bestmed Medical Scheme. The amount of the late-joiner penalty will depend on the years the individual was not enrolled in a medical plan.   The penalty will be calculated using a sliding scale and added to the individual’s monthly high-risk contribution, as shown in the table below.  The following table shows how Bestmed Medical Scheme applies late joiner fees:     Effective 1 April 2001, the total number of years beginning at age 35 will be considered. In addition, members should note that the late-joiner penalty only applies to the risk contribution, not the PMSA.  

Bestmed Medical Scheme Waiting Periods

  Depending on pre-existing or existing conditions, the following might apply when you register for medical cover with Bestmed Medical Scheme:  

• ✅ A 3-month general waiting period in respect of all benefits.
• ✅ A 12-month exclusion in respect of a pre-existing condition.

    Finally, a late-joiner contribution penalty will apply.  

Bestmed Medical Scheme Exclusions

  Some of the following are excluded from Bestmed’s medical aid plans. The comprehensive list can be found on the official Bestmed website.  

• ☑️ Any fees associated with patient and medical staff travel.
• ☑️ Medical aids, orthopedic, surgical, and medical appliances, excluding those described in Annexes B.1 to B.4 of the Scheme Regulations and those prescribed for treating specific PMB disorders and available in the public sector.
• ☑️ Requested reports, examinations, tests for emigration, immigration, visas, insurance policies, employment, admission to schools and universities, court medical reports, muscle-function tests, fitness examinations and testing, adoption of children, and retirement due to ill health.
• ☑️ Any non-functional or cosmetic procedures, operations, or treatments.
• ☑️ Accounting for services performed by individuals not registered with the Health Professionals Council of South Africa, the Associated Health Service Professions Board, or a comparable healthcare organization in the nation where the service was rendered.

  Accounts regarding the following:  

• ☑️ The costs incurred for treating illness conditions or injuries received by a member or dependent for whom another party is responsible.
• ☑️ Preventative devices and medications for sports and recreational activities.
• ☑️ Injuries resulting from illegal actions in which the member or their dependents participated in a criminal crime, excluding those recommended in treating specific PMB conditions and available in the public sector.

  Unkept appointments by members, and more.  

Bestmed Medical Scheme and Pre-existing Conditions

  When joining a medical aid scheme, it is important to note that there is usually a waiting period of 12 months before any pre-existing conditions are covered.   Therefore, joining a medical aid scheme earlier in life is advisable, rather than waiting until old age when the risk of developing chronic health conditions is higher. Additionally, it is important to note that some medical aid schemes, such as Bestmed Medical Scheme, have specific policies regarding pre-existing conditions.   Therefore, it is important to research and understands the policies of a medical aid scheme before joining to ensure that you are fully aware of any waiting periods or limitations regarding pre-existing conditions.  

Late Joiner Fees vs. Waiting Periods: What is the Difference?

  Late Joiner Fees are a one-time penalty fee charged by medical aid if you join after a certain age or have never been a member of a medical aid program. Waiting periods, on the other hand, are periods during which you are not covered for certain medical aid benefits.   These waiting periods apply to all new members, regardless of whether they are charged Late Joiner Fees. Depending on the benefit, waiting periods can range from three to twelve months.   👉🏿 Read more: Late Joiner Penalties Explained

What Happens if You Do Not Pay Late Joiner Fees?

  Your medical aid membership may be suspended or terminated if you fail to pay the Late Joiner Fees. The scheme may also pursue legal action to collect overdue fees.  If your membership is suspended, you cannot access medical aid benefits until you have paid any outstanding fees.   If your membership is terminated, you must reapply for membership and may be subject to even higher Late Joiner Fees. Therefore, paying your Late Joiner Fees on time is crucial to prevent interruptions in your medical aid coverage.  

National Health Insurance (NHI) Bill South Africa

  In South Africa, the NHI is a proposed universal health coverage system. It is still in the planning stages, but it could affect Late Joiner Fees and other facets of medical aid.  

Our Verdict on Bestmed Medical Scheme Late Joiner Fees

  💙 Overall, prospective members over the age of 35 may view the late joiner fees of Bestmed as both advantageous and disadvantageous.  On the one hand, the fees ensure that members who have not paid into a medical plan for an extended period are not unfairly subsidized by those who have paid for an extended period.   💙 Furthermore, the fees may also assist in stabilizing the risk pool of the medical plan by reducing adverse selection and encouraging greater participation among healthy individuals.   💙 On the other hand, the late joiner fees may be perceived as a significant financial burden by those who are new to the scheme or who have not been members of a medical scheme for an extended period.    

Bestmed Medical Scheme Late Joiner Fees Frequently Asked Questions

 

How does Bestmed Medical Scheme calculate late joiner fees?

Late joiner fees are calculated as a percentage of the member’s monthly contribution (from 0.05% up to 0.75%), proportional to the number of years the member was eligible to join a medical plan but did not.  

Can I avoid paying late joiner fees with Bestmed Medical Scheme?

By law, late joiner fees are mandatory and cannot be avoided. However, the late-joiner fees can be reduced by providing evidence of prior membership in a medical plan.  

What is the maximum late joiner fee charged by Bestmed Medical Scheme?

Bestmed Medical Scheme’s maximum late joiner fee is 75% of the member’s monthly contribution.  

When do I need to pay late joiner fees with Bestmed Medical Scheme?

Late joiner fees are due when a member joins Bestmed Medical Scheme for the first time, has never been a member of another medical plan, or has had a lapse in membership.  

Is it possible to negotiate late joiner fees with Bestmed Medical Scheme?

The law stipulates that late joiner fees cannot be negotiated. However, the fees can be reduced by proving previous membership in a medical plan.  

How do I apply for membership with Bestmed Medical Scheme as a late joiner?

To apply for membership with Bestmed Medical Scheme as a late applicant, you must complete an application form and submit it to the scheme along with all the required documentation, including proof of previous medical scheme membership, if applicable.  

Will my pre-existing conditions be covered if I pay late joiner fees with Bestmed Medical Scheme?

Yes, pre-existing conditions will be covered if you pay Bestmed Medical Scheme’s late joiner fees. However, there may be waiting periods for cover of these conditions.  

How does Bestmed Medical Scheme compare to other schemes regarding late joiner fees?

Bestmed Medical Scheme’s late-joiner fees are comparable to other South African medical schemes.  

What happens if I do not pay my late joiner fees with Bestmed Medical Scheme?

If you do not pay your Bestmed Medical Scheme late joiner fees, your membership could be terminated, and you will be unable to use the scheme’s benefits.