KeyHealth Late Joiner Fee

Overall, KeyHealth is a trustworthy and comprehensive medical aid provider. New Members 35 years or older may be subject to late-joiner penalties on KeyHealth Medical Aid Plans. The KeyHealth Medical Aid Plans start from R1500 ZAR per month. KeyHealth has a trust rating of 4.1.

KeyHealth Late Joiner Fees – 9 Key Point Quick Overview

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

KeyHealth Late Joiner Fees – What to know before Joining

If you are 35 or older and have not been a member or dependent of a recognized medical scheme continuously since 1 April 2001, without a break in cover exceeding 90 days since that date, you could be subject to a premium loading (late joiner penalty).

Furthermore, this fee is a permanent deduction from your membership dues, determined by the years in which a medical scheme did not cover the individual after turning 35. In addition, credit is given for years in which the individual was covered after age 21.

The penalties imposed by KeyHealth are as follows:

KeyHealth Waiting Periods

KeyHealth could withhold certain benefits and cover for up to a year if a Principal Member or they are dependent is diagnosed with a specific illness.  The following are examples of possible waiting periods:

• ✅ PMB conditions are included in the standard waiting period of up to three months.
• ✅ A pre-existing condition (PMB) waiting period of up to 12 months.

If an applicant for membership or dependent admission has not been a beneficiary of a medical scheme for at least 90 days before the application date, KeyHealth could impose waiting periods, subject to the regulations.

KeyHealth Exclusions

The KeyHealth’s medical aid options have the following specific exclusions, with the complete list available on the scheme’s official website:

• ✅ Acupuncture
• ✅ Bio-stress assessments
• ✅ Colonic irrigation
• ✅ Conservative back/neck treatment in the hospital
• ✅ Cosmetic / non-functional procedures
• ✅ DNA testing
• ✅ Gender reassignment
• ✅ Industrial and educational psychologists
• ✅ IQ tests and learning or educational problems
• ✅ Music and water therapy
• ✅ Obesity and weight loss surgery (excluding benefits available on the Health Booster)
• ✅ Polysomnogram and titration (sleep study)
• ✅ Reversal of sterilization
• ✅ Reversal of vasectomy
• ✅ Sclerotherapy of varicose veins
• ✅ Sonography and sonographer
• ✅ Therapeutic reflexology
• ✅ VAC instillation therapy, including Pico and Prevena dressings.

and many more. A full list of exclusions will be made available by KeyHealth.

KeyHealth and Pre-existing Conditions

When joining a medical aid scheme, it is essential 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 KeyHealth, 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.

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 KeyHealth Late Joiner Fees

KeyHealth is a health insurance plan that covers various medical services. The plan includes a wellness component, chronic disease management tools, and access to a wide range of medical professionals.  KeyHealth members who join after the age of 35 or who have a gap in medical scheme cover are subject to a late joiner penalty.

The penalty is a set percentage of the member’s initial contribution. It is meant to reflect the higher risk profile of late enrollees.  KeyHealth has waiting periods for maternity benefits and pre-existing conditions in addition to the late joiner penalty.

These periods are in place to discourage people from joining the plan solely to gain access to cover for costly treatments right away.

KeyHealth Late Joiner Fees Frequently Asked Questions

What are Late Joiner Fees?

Individuals who join KeyHealth after a certain age or after an interruption in medical scheme cover are subject to late joiner fees.

Why do Medical Aids Charge Late Joiner Fees?

KeyHealth charges late joiner fees to account for the higher likelihood of claims from older or higher-risk individuals.

How are Late Joiner Fees Calculated?

KeyHealth’s late joiner fees are a percentage of the member’s contribution. Furthermore, the member’s age determines them and the length since they last belonged to a medical scheme.

Who is Affected by Late Joiner Fees?

People over 35 who have never belonged to a medical scheme or who had a break in medical scheme cover will be subject to KeyHealth’s late joiner fees.

When is the Best Time to Join a Medical Aid?

To avoid late joiner fees and waiting periods for certain benefits, you should join KeyHealth as soon as possible, preferably before turning 35.

What Are the Alternatives to Joining a Medical Aid Scheme?

Hospital insurance and public healthcare services are two alternatives to joining KeyHealth. However, they may not offer the same level of cover.

How Do Late Joiner Fees Affect Your Medical Aid Benefits?

KeyHealth’s late-joiner fees may increase a member’s contribution and delay coverage for certain benefits, such as those for pre-existing conditions or pregnancy.

Can You Waive Late Joiner Fees?

If you can show proof of previous medical scheme membership or are joining within a certain time after leaving your previous medical scheme, KeyHealth may be willing to waive your late joiner fees.