CompCare Late Joiner Fee

  Overall, CompCare is a trustworthy and comprehensive medical aid provider. New Members 35 years or older may be subject to late-joiner penalties on CompCare Medical Aid Plans. The CompCare Medical Aid Plans start from R995 ZAR per month on DigiCare. CompCare has a trust rating of 3.4.  

CompCare Late Joiner Fees - 9 Key Point Quick Overview

1. ✅ CompCare Late Joiner Fees - What to know before Joining
2. ✅ CompCare Waiting Periods
3. ✅ CompCare Exclusions
4. ✅ CompCare 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 CompCare Late Joiner Fees
9. ✅ CompCare Late Joiner Fees Frequently Asked Questions

CompCare Late Joiner Fees - What to know before Joining

If an applicant or adult dependent of an applicant is older than 35 on the date of application for membership or admission, dependent or late joiner penalties could apply based on the number of years the individual has gone without membership in a registered South African medical scheme.   Beneficiaries who have had continuous cover with one or more medical schemes since 1 April 2001, with no gaps in cover lasting more than three months, are not included in this definition.   Any fines imposed cannot be more than the maximum amount indicated below and will only be assessed on the contribution proportion corresponding to the late joiner. These are as follows:     💙 The Late Joiner Fee applies to all CompCare Plans, including:  

• ExecuCare
• UltraCare Plus
• UltraCare
• ExtraCare
• SaverCare Plus
• SelfCare Plus
• DigiCare
• SelfCare
• SuperCare+
• SaverCare

CompCare Waiting Periods

  Members-to-be are expected to be completely transparent about their health histories. In addition, there are enrollment and dependent registration waiting periods.   The following is applicable in terms of CompCare:  

• ✅ If you go more than 90 days without being enrolled in a health insurance plan, you might have to endure a three-month waiting period before receiving treatment for any pre-existing conditions.
• ✅ If applying for membership less than 24 months after leaving a previous medical scheme, a condition-specific waiting period of 12 months may be imposed.
• ✅ A general waiting period of 3 months will apply if you applied for membership within 3 months of terminating from a previous scheme and were on a medical scheme for more than 24 months.
• ✅ Waiting periods do not affect access to the Prescribed Minimum Benefits.

  Finally, there is a standard three-month waiting period for new members and their dependents.    

CompCare Exclusions

  The following are some of the items that CompCare does not cover, with the full list available on the official CompCare website:  

• ✅ The scheme will not pay for expenses that exceed the annual maximum benefit.
• ✅ A general waiting period of 3 months may be applied to new members and their dependents according to the scheme rules.
• ✅ According to the scheme rules, a condition-specific waiting period of up to 12 months may be applied for pre-existing sickness conditions.
• ✅ The scheme will not cover any costs incurred during waiting periods.
• ✅ Certain professional fees and expenses incurred by healthcare professionals will not be covered, such as after-hours consultations at the member’s choice, unattended appointments, interest charges by healthcare providers, costs incurred for insurance medical purposes, fees for medical reports, and motivations unless required by the scheme, and discretionary conditions and services with unauthorized hospital admissions.
• ✅ Costs for services rendered by unregistered professionals or institutions, except state or provincial hospitals registered under South African law, will not be covered.

  Frail care services will not be covered, including accommodation and nursing care in convalescent or nursing homes catering to the aged or chronically ill.  

CompCare 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 CompCare, 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 CompCare Late Joiner Fees

💙 CompCare is a medical aid scheme offering various options for individuals seeking medical aid coverage. However, the late joiner fees can be significant, and the scheme is only available in certain areas of South Africa.   💙 Late joiner fees are applied to individuals who have not joined a medical aid scheme by 35 or who have had a break in membership of more than 90 days. The fees are calculated based on the individual’s age and the number of years they have been without medical aid cover.   💙 Furthermore, these fees can be substantial and are meant to discourage individuals from waiting until they are older or have a medical condition before joining a scheme.    

CompCare Late Joiner Fees Frequently Asked Questions

What are late joiner fees for CompCare?

Late joiner fees, also known as late joiner penalties or loadings, are additional fees charged to individuals who join a medical aid scheme after the age of 35 or after a certain period has passed since they first became eligible to join.  CompCare imposes a late joiner penalty of 5% for each year that the individual was eligible but did not join.  

When do I have to pay late joiner fees for CompCare?

You will have to pay late joiner fees for CompCare if you join the medical aid scheme after age 35 or after a certain period has passed since you first became eligible to join.  The period you have to join without incurring late joiner fees varies depending on the medical aid scheme and the specific plan you choose.  

Can I avoid paying late joiner fees with CompCare?

Yes, you can avoid paying late joiner fees with CompCare by joining the medical aid scheme before 35 or before the end of the waiting period.  You may also avoid late joiner fees if you prove that you were covered by another medical aid scheme or employer’s medical scheme during the period you were eligible to join CompCare.  

How much are late joiner fees for CompCare?

The late joiner penalty for CompCare is 5% for each year that you were eligible for but did not join. The maximum penalty that can be charged is 30%, which means that if you wait more than six years to join, you will be charged the maximum penalty.  

What is the compulsory waiting period for CompCare?

The compulsory waiting period for CompCare is when you must wait before you can start using the medical aid scheme’s benefits. The waiting period for CompCare is usually three months. However, it could be longer for certain benefits, such as maternity benefits.  

Can I waive the waiting period for CompCare?

In some cases, you may be able to waive the waiting period for CompCare. For example, if you are joining CompCare within 90 days of leaving another medical aid scheme or employer’s medical scheme, you may be able to waive the waiting period.  You may also be able to waive the waiting period for certain benefits, such as chronic medication or emergency medical treatment.  

What are the benefits of joining CompCare as a late joiner?

Although joining CompCare as a late joiner could result in additional fees, it can still be beneficial if you need medical aid coverage.  CompCare offers a range of benefits, including hospital coverage, chronic medication benefits, and wellness programs. As a member, you can also access a network of healthcare providers at discounted rates.  

Can I switch to CompCare from another medical aid scheme without incurring late joiner fees?

If you are switching to CompCare from another medical aid scheme, you could avoid late joiner fees if you can prove that you were covered by the other scheme when you were eligible to join CompCare. However, you might still be subject to waiting periods.