Sizwe Hosmed Late Joiner Fee

(🇿🇦 2025*)

Overall, Sizwe Hosmed is a trustworthy and comprehensive medical aid provider. New Members, 35 years or older may be subject to late-joiner penalties on Sizwe Hosmed Medical Aid Plans. The Sizwe Hosmed Medical Aid Plans start from R1,054 ZAR per month. Sizwe Medical Scheme has a trust rating of 3.9.

Sizwe Hosmed Late Joiner Fees – 9 Key Point Quick Overview

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

Sizwe Hosmed Late Joiner Fees – What to know before Joining

💙 If you are considering joining Sizwe Hosmed medical scheme after turning 35 and have never been a member of a medical scheme before, or if you have had a break in your membership, you may face late-joiner penalties.

💙 These penalties can range from 5% to 75% of your contributions and may be applicable for the rest of your life. Therefore, it is essential to consider these penalties before joining or taking a break from your membership.

💙 Late-joiner penalties protect medical schemes like Sizwe Hosmed from people who only join when sick and need to claim. As a result, medical schemes rely on younger and healthier members to help balance the costs for older and sicker members.

💙 Furthermore, the penalties ensure that everyone contributes fairly. The penalties for Sizwe Hosmed are calculated using a formula that considers the number of years you have not been a scheme member after turning 35.

💙 This involves adding up the number of years you have been a scheme member since turning 35, adding 35, and subtracting this answer from your age when you join the scheme.

💙 Therefore, it is important to note that years spent out of the country or with health insurance do not count as years of coverage when calculating late-joiner penalties.

Sizwe Hosmed Waiting Periods

💙 When new members join Sizwe Hosmed, they could be subject to a three-month general waiting period during which they cannot receive benefits.  Except in the case of Prescribed Minimum Benefits, if the new member has a pre-existing ailment, they could be subject to a one-year condition-specific waiting period.

Sizwe Hosmed Exclusions

💙 Sizwe Hosmed indicates that the following are excluded. However, these are only a few items; the complete list can be viewed on the Sizwe Hosmed website.

• ✅ Costs that exceed the annual or biennial maximum allowed for the category
• ✅ Operations, medicines, treatments, and procedures for cosmetic purposes or personal reasons
• ✅ Medical service not deemed necessary by the medical advisor for the management of the medical condition
• ✅ Treatment with no proven efficacy and safety
• ✅ Services rendered by unregistered persons or institutions not registered in terms of any law
• ✅ Abdominoplasties and repair of divarication of abdominal muscles
• ✅ Geriatric hospital, nursing home, frail care facility, or similar accommodations and services
• ✅ Alternative therapists, such as art therapists, aromatherapists, massage therapists, reflexologists, and Chinese medicine practitioners
• ✅ Anabolic steroids and immunostimulants, excluding immunoglobulins and growth hormones
• ✅ Ante- and postnatal exercises
• ✅ Ozone therapy
• ✅ Polishing of restorations
• ✅ Pulp capping (direct and indirect)
• ✅ Root canal treatment and laboratory fabricated crowns on primary teeth
• ✅ Fissure sealants on patients older than 16 years

💙  A full list of exclusions will be made available by Sizwe Hosmed.

Sizwe Hosmed 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 Sizwe Hosmed, 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 Sizwe Hosmed Late Joiner Fees

💙 Overall, South Africans who join the Sizwe Hosmed medical scheme after turning 35 and who have not been members of a registered medical scheme or had active cover for the preceding 24 months are subject to late joiner penalties.

💙 Depending on how long you went without health insurance after turning 35, the penalty could be anywhere from 5%to 75% of your contribution. The one-time membership fee is in addition to the regular monthly administration fee.

💙 Furthermore, Sizwe’s benefits for members range from preventative care to hospitalization to chronic medicine. The plan also supports members’ wellness and disease management.

💙 Despite the costs involved, late joiner fees and other costs at Sizwe Hosmed are comparable to those in the industry overall. Furthermore, generous benefits and services counterbalance them.

Sizwe Hosmed Late Joiner Fees Frequently Asked Questions

What is Sizwe Hosmed’s late joiner penalty?

People who join the Sizwe Hosmed medical scheme after turning 35 and who have never belonged to a medical scheme before or who have had a break in their medical scheme cover are subject to a late joiner penalty.

How is the waiting period determined for late joiners at Sizwe Hosmed?

Late joiners at Sizwe Hosmed have different wait times based on their medical history and any pre-existing conditions.

Are there any exclusion periods for late joiners at Sizwe Hosmed?

Depending on the patient’s medical history, Sizwe Hosmed could impose waiting periods before covering treatment for a late-arriving patient’s pre-existing condition.

Can a late joiner at Sizwe Hosmed apply for membership during an open enrollment period?

During open enrollment, a late joiner can apply for membership at Sizwe Hosmed, but they may still be charged a fee.

Is there a late application fee for late joiners at Sizwe Hosmed?

Late applicants to Sizwe Hosmed will not incur a late application fee. However, they may still be subject to late joiner penalties.