Momentum Late Joiner Fee
Overall, Momentum Medical Scheme is a trustworthy and comprehensive medical aid provider. New Members 35 years or older may be subject to late-joiner penalties on Momentum Medical Aid Plans. The Momentum Medical Aid Plans start from R482 ZAR per month. Momentum Medical Scheme has a trust rating of 4.3.
| 🟥 Medical Aid | 🔎 Momentum |
| 🟧 Waiting Period | Possible |
| 🟨 Late Joiner Fee | Possible |
| 🟩 Plans (from) | R482 ZAR |
| 🟦 Trust Rating | 4.3 |
Momentum Medical Scheme Late Joiner Fees – 9 Key Point Quick Overview
- ✅ Momentum Medical Scheme Late Joiner Fees – What to know before Joining
- ✅ Momentum Medical Scheme Waiting Periods
- ✅ Momentum Medical Scheme Exclusions
- ✅ Momentum Medical Scheme and Pre-existing Conditions
- ✅ Late Joiner Fees vs. Waiting Periods – What is the Difference
- ✅ What Happens if You Do Not Pay Late Joiner Fees
- ✅ National Health Insurance (NHI) Bill South Africa
- ✅ Our Verdict on Momentum Medical Scheme Late Joiner Fees
- ✅ Momentum Medical Scheme Late Joiner Fees Frequently Asked Questions
Momentum Medical Scheme Late Joiner Fees – What to know before Joining
Momentum Medical Scheme applies late joiner fees to members who join the scheme after 35 and who have not had previous medical scheme membership. Furthermore, the Medical Schemes Act (No. 131 of 1998) regulates the late joiner fees for Momentum Medical Scheme.
Fees are calculated based on the number of years that the applicant has been without a medical scheme membership since the age of 21. Furthermore, the Act allows a maximum of 5 years to be disregarded.
Momentum Medical Scheme Waiting Periods
Depending on pre-existing or existing conditions, the following may apply when you enroll with Momentum Medical Scheme, regardless of the plan:
- A general waiting period of three months for all benefits.
- A twelve-month exclusion for pre-existing conditions.
Finally, a penalty for late-joiner contributions may apply.
Momentum Medical Scheme Exclusions
Even though there are limitations and exclusions, Momentum members are still entitled to Prescribed Minimum Benefits (PMBs). In addition, the following expenses are not covered by Momentum but could be reimbursed from a Medical Savings Account:
- Costs during waiting periods or for conditions not disclosed during application.
- Costs exceeding the annual maximum for the specific category as set out in Annexure B of the Scheme Rules.
- Injuries sustained during participation in a riot, civil commotion, war, invasion, terrorist activity, or rebellion.
- Professional speed contests or trials.
- Treatment by a health care provider not registered with a recognized professional body constituted in terms of an Act of Parliament.
- Holidays for recuperative purposes, including headache and stress relief clinics.
- Treatment for which efficacy and safety cannot be proved.
- Operations, medicine, treatments, and procedures for cosmetic purposes unrelated to illness, accident, or disease.
- Obesity
- Costs for attempted suicide that exceed Prescribed Minimum Benefits limits.
- Certain cosmetic surgeries include breast reduction, augmentation, gynecomastia, otoplasty, and blepharoplasty.
- Medication not registered by the Medicine Control Council.
- Services rendered by institutions not registered in terms of any law (except for State facilities/hospitals).
- Gum guards and gold are used in dentures.
and many more. A Full list of exclusions will be made available by Momentum.
Momentum Medical Scheme 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 Momentum 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.
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 Momentum Medical Scheme Late Joiner Fees
Overall, Momentum Medical Scheme is a reputable medical aid scheme in South Africa that applies late joiner fees to members who join the scheme after 35 and who have not had previous medical scheme membership.
While late joiner fees may be seen as a potential barrier to entry, they are designed to ensure that medical schemes remain sustainable and can provide members with comprehensive healthcare coverage.
As such, it is important for individuals considering the Momentum Medical Scheme to carefully weigh the potential costs and benefits of joining the scheme.
Momentum Medical Scheme Late Joiner Fees Frequently Asked Questions
What are the late joiner fees for Momentum Medical Scheme?
The Momentum Medical Scheme late joiner fees depend on your age and length of time without medical cover. The fees are calculated as a percentage of your monthly premium and increase each year you delay enrolling in a medical plan.
How does Momentum Medical Scheme calculate late joiner fees?
Momentum Medical Scheme calculates late enrollment fees using a formula provided by the Council for Medical Schemes. The formula considers your age at the time of enrollment, the number of years you have gone without health insurance, and the number of dependents you wish to include on your membership.
Can I avoid paying late joiner fees with Momentum Medical Scheme?
Late joiner fees are mandatory for all South African medical plans, including Momentum Medical Scheme. There are exceptions, however, including if you have had continuous medical scheme cover or are joining a medical scheme at an early age.
What are the consequences of not joining the Momentum Medical Scheme on time?
If you miss the deadline to enroll in a medical plan, you must pay late enrollment fees. You may also be subject to waiting periods for certain benefits and lack access to comprehensive medical coverage.
Are late joiner fees applicable to all medical schemes in South Africa?
Yes, late joiner fees are a requirement for all South African medical plans. The fees are intended to encourage individuals to enroll in medical plans early in life and dissuade them from enrolling only when they become ill or require medical treatment.
How do late joiner fees differ between medical schemes in South Africa?
The Council for Medical Schemes determines late joiner fees which are uniformly applied across all South African medical schemes. The fees may vary, however, based on the age and health status of the individual enrolling in the medical plan.
Can I negotiate the late joiner fees with Momentum Medical Scheme?
The Council for Medical Schemes determines and imposes non-negotiable late joiner fees. However, you may be eligible for a fee reduction if you join a medical plan at an early age or can demonstrate continuous coverage.
Is there a cap on late joiner fees with Momentum Medical Scheme?
Yes, Momentum Medical Scheme’s late joiner fees are subject to a cap. The Council for Medical Schemes determines and adjusts the maximum fee that can be charged annually.
