4 Best Medical Aids with No Late Joiner Penalty
The 4 Best Medical Aids with No Late Joiner Penalty in South Africa revealed.
We tested them side by side and verified their medical aid plans.
This is a complete guide to the best medical aid with No Late Joiner Penalty in South Africa.
In this in-depth guide you’ll learn:
- 👉🏿 What is a Medical Aid?
- 👉🏿 What is a late joiner penalty?
- 👉🏿 Why do medical aids charge late joiner penalties?
- 👉🏿 How much are late joiner penalties usually?
- 👉🏿 When do you not get charged with a late joiner penalty?
So if you’re ready to go “all in” with the best medical aid with No Late Joiner Penalties in South Africa, this guide is for you.
Let’s dive right in…
Best Medical Aids with No Late Joiner Penalty (2024)
🩺 Medical Aid | ✔️ Offers Plans with No Late Joining Penalties? | ⚕️ Plan Offered | 👉 Sign Up |
1. Discovery Health | New members 35 or older may be subject to late-joiner penalties | Discovery KeyCare Plan | 👉 Apply Now |
2. Bonitas | New members 35 or older may be subject to late-joiner penalties | Boncap Student | 👉 Apply Now |
4. FedHealth | New members 35 or older may be subject to late-joiner penalties | flexiFED Savvy | 👉 Apply Now |
5. Momentum Medical Aid | New members 35 or older may be subject to late-joiner penalties | Ingwe Student Option | 👉 Apply Now |
📌 Notice: Late joiner penalty
All new members are subject to a late joiner penalty should the member be older than 35 years old. Below in this article you will find more information regarding the later joiner penalty of each medical aid scheme.
📌 Notice: Waiting period
It is important to ensure that you understand the difference between late joiner penalty and waiting periods.
4 Best Medical Aids with No Late Joiner Penalty Summary
- Discovery Medical Scheme – Overall, Best Medical Aid with No Late Joiner Penalty Fees
- Bonitas Medical Aid Scheme – Top Extensive Medical Protection in South Africa
- Fedhealth Medical Scheme – Best Pay-As-You-Go Private Healthcare
- Momentum Health Medical Scheme – Best Customer Service Medical Aid
Introduction to Late Joiner Penalties
👉🏿 The late-joiner penalty is one of the most burdensome underwriting techniques that medical all schemes in South Africa have at their disposal and use.
👉🏿 There are no medical aid schemes that do not impose later joiner penalties. This penalty may be as high as 75% of your medical assistance risk contribution and may apply for the whole period of a membership.
👉🏿 People over the age of 35 who were neither dependents or members of a local medical plan prior to April 1, 2001 are eligible for a contribution loading under the Medical Schemes Act.
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What is a late joiner penalty?
👉🏿 A late joiner penalty is an additional monthly price that is applied to the medical aid premium for any member who joins a plan beyond the age of 35 years old. It is determined by the number of years that a person has gone without medical aid coverage and the number of years that have passed since the individual turned 35 when they joined the plan.
👉🏿 As a result, the amount of this penalty might range anywhere from 5% to 75% of the monthly medical aid subscription.
👉🏿 Members of medical aid who switch from one plan to another are exempt from the late joiner penalty that would otherwise apply to them. However, if a medical aid that was transferring between plans was assessed the penalty by the prior plan, then that penalty also applies to membership in the new plan. In a similar vein, a late joiner penalty might not be imposed on a new member of the medical aid programme who received coverage within the previous ninety days.
☑️ READ more about the 5 Best Hospital Plans for People over 60 years and Receivers of SASSA in South Africa.
Why do medical schemes charge late joiner penalties?
☑️ Before attempting to comprehend the late joiner penalty, it is necessary to first get an understanding of the operation of various medical plans. Medical schemes are non-profit organisations (NPOs) that pool the payments of members and pay for essential healthcare expenditures for those members of the medical scheme who make a claim.
☑️ The administrator of the programme has the ability to collect a nominal fee in exchange for the services they provide; hence, the administrator may be a for-profit organisation or enterprise.
☑️ Because of this, medical plans frequently rely on the young and healthy members to finance the expenditures incurred by the elderly and sick members. However, the scheme’s resources are unfairly taxed when a person enrols in a medical plan only when they need it (already ill) or later in life (after the age of 35 years, when disease is more likely). As a result, medical plans incorporate waiting periods and fines into their policies.
👉🏿 Discover the importance of Gap Cover
Categories of Late Joiners
There are different categories of “late joiners”:
Category A
For members that have not belonged to a medical aid scheme before or members that have allowed more than 90 days break since resigning from their previous medical aid, a 3 month general waiting period may be imposed, and a 12 month condition specific waiting periods may be imposed on pre-existing conditions. A Late Joiner Penalty may also apply.
Category B
Members who have belonged to a previous medical aid scheme for less than 2 years and allowed less than 90 days break since resigning from their previous medical aid can get a 12 month condition specific waiting period on pre-existing conditions that have occurred in the last 12 months and late Joiner Penalties may be imposed on them.
Category C
For members who have belonged to a previous medical aid scheme for more than 2 years and allowed less than 90 days break since resigning from their previous medical aid, Late Joiner Penalties may be imposed.
👉🏿 The variables that are considered when calculating the late joiner penalty are:
- ✔️ Current age of medical aid member
- ✔️ Number of years of prior medical aid cover
👉🏿 Older members are penalised this way. There are instances in which more senior members may not have been able to buy coverage earlier in their lives. The late joiner penalty, which looks to “discriminate” against the elderly, might make it financially impossible for retirees to obtain medical assistance.
👉🏿 On the other hand, in spite of the fact that a person is punished for joining a medical aid later in life, it is essential to remember that, as is the case with any type of insurance, one should look for protection at times when it is not yet necessary to do so.
👉🏿 A medical plan is financially liable to each and every one of its participants. In addition to ensuring that the programme is managed effectively, it is also responsible for preventing existing medical aid members from being unduly disadvantaged by new members. Naturally, persons who are older are more likely to require a greater degree of medical care, which might put a burden on the resources available via the programme.
👉🏿 Because of this, it is usually recommended to sign up for a medical aid programme as soon as possible in life, rather than waiting until it is absolutely necessary to do so.
Disadvantages for senior persons
✔️ If you are a senior person and you wish to use private healthcare services, medical aid is more important than ever. Unfortunately, some retirees could discover that they cannot afford medical aid. In South Africa, medical plans are not allowed to impose age restrictions on its members. This indicates that regardless of a person’s age, they are able to join a medical aid and continue receiving coverage from that medical aid throughout their lives in South Africa.
✔️ However, there are clear benefits to enrolling in a medical aid programme as early in life as feasible, particularly given the fact that beginning coverage at a later age comes at a substantially higher cost.
✔️ Unless the member is above the age of 35 years, medical aids are not allowed to charge different fees for members who are enrolled in the same plan and choice. A late joiner penalty is imposed to monthly payments (also known as medical aid premiums). It varies from person to person and can make coverage costly, particularly for medical aid recipients in their later years.
✔️ Penalties for late joiners also do not disappear once a predetermined amount of time has passed. It is a penalty cost that will continue to be applied to the monthly donation for the length of the membership. It is computed at the time of beginning coverage for the medical aid programme, and it is then relevant after that. These sanctions can be levied against either the primary member of the scheme or any adult dependent on them.
✔️ The amount will vary according to the number of years that the member has gone without belonging to a medical aid plan. It is calculated as a percentage of the contribution and its amount is determined by the total number of years that a member has not been enrolled in a medical aid plan after reaching the age of 35.
READ more about Best Gap Cover with No Waiting Period in South Africa compared
1. Discovery Medical Scheme
✔️ There are over twenty distinct health plan choices available via the Discovery Health Medical Scheme. All of these plans are appropriate for young people since they provide unrestricted coverage for private hospital stays as well as a variety of additional benefits that may be tailored to each individual’s preferences and budgetary constraints.
📌 Notice: Read more about Discovery health late joiner fee.
✔️ The plans provide access to a variety of benefits, care plans, and services that ensure any young adult will receive the highest quality medical care whenever it is required of them.
✔️ You also have the opportunity to participate in Vitality, the company’s wellness programme, which recognises and commends you for living a healthy lifestyle by providing you with prizes such as free gym memberships and other perks.
✔️ The management of the Scheme, which is owned by its participants, is governed by a Board of Trustees that is separate from the Scheme itself. A separate company, Discovery Health (Pty) Ltd., which is licenced as a supplier of regulated financial services, is in charge of its administration. The Discovery Health Medical Scheme is subject to regulation by both the Medical Schemes Act and the Council for Medical Schemes.
✔️ The Discovery option plans vary from the most all-inclusive but also the priciest private healthcare coverage to the most fundamental and cost-effective plans, which give cost-effective private healthcare coverage through an extensive provider network.
Comprehensive Series
The Comprehensive series of plans provide comprehensive cover for in-hospital and day-to-day cover with extended chronic medicine cover and unlimited Above Threshold Benefit. With its fairly high premiums, only young adults already established in a secure job may consider this.
Priority Series
The Priority Series of plans offer cost-effective in-hospital cover, essential chronic medicine cover and day-to-day benefits with a limited Above Threshold Benefit, which is ideal for young professionals.
Saver Series
The Saver series of plans is economical, provides in-hospital cover, essential chronic medicine cover and day-to-day benefits through a Medical Savings Account. Its premiums are reasonable, therefore many young adults become members.
Core Series
The Core Series of plans is a value-for-money series of hospital plans that provide unlimited private hospital cover and essential cover for chronic medicine to young adults who do not have a big income. The benefits do not include any day-to-day cover.
Smart Series
The Smart series of plans provide the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover for young adults if they use providers in a specified network.
2. Bonitas Medical Aid Scheme
✔️ Since Bonitas has been in business for close to 40 years, the company has had the time to cultivate a deep tradition and acquire an in-depth understanding of the South African private healthcare industry.
✔️ Therefore, whether it is keeping a finger on the pulse of technological advancements, managing your care so that lifestyle diseases are identified before they become chronic, or negotiating better rates for you, its team of experts is constantly looking for innovative ways to ensure that members receive affordable, quality healthcare. This could include keeping a finger on the technological pulse, managing your care so that lifestyle diseases are identified before they become chronic, or negotiating better rates for you.
✔️ If you are one among the more than 700,000 beneficiaries, you have the opportunity to take advantage of the company’s more affordable rates and dependable service providers in order to maintain your health and reduce the overall cost of medical treatment.
✔️ The broad variety of plans offered by Bonitas ensures that you and your family will be able to choose one that is a good fit for your particular needs and preferences. The programmes are developed to be user-friendly while while increasing the amount of advantages you receive. If you are a young adult seeking for your first time medical insurance, Bonitas is an option for you.
✔️ A management team with a lot of expertise and an independent Board of Trustees made up of professional non-members from the health, legal, financial, and business domains administer Bonitas. These professionals are not members of the organisation.
✔️ Bonitas offers a wide variety of plans, several of which are suitable for young adults.
✔️ The plans are easy to understand and use so that young members can get the most out of their benefits.
📌 Notice: Read more about the late joiner penalty of Bonitas Medical Aid
Edge Plans
✅ This category gives access to day-to-day benefits including unlimited GP consultations, layers of virtual care, dental and optical consultations, a private hospital network and more.
✅ Options include the BonStart plan, designed for economically active singles, living in the larger metros, with a drive to succeed and BonStart Plus, designed for young, economically active couples, living in the larger metros, and looking to expand their family.
Traditional Plans
✅ The traditional plans are suitable for young adults who are already more settled and financially independent. The give an overall day-to-day limit with sub-limits for GP and specialist consultations, acute and over-the-counter medicine, X-rays and blood tests and other out-of-hospital medical expenses. Options include a Standard, Standard Select, Primary and Primary Select plan.
✅ This traditional options offers good day-to-day benefits and comprehensive hospital cover, with the Select plans using a network of quality providers to offer modest day-to-day benefits and hospital cover.
Savings Plans
✅ You can also consider one of Bonitas’ Saving plans that give a set amount that you can use however you want for out-of-hospital costs like doctor visits, optometry, and dentistry. They also cover you while you’re in the hospital and give you extra benefits for maternity, wellness, and preventative care.
✅ The options are called BonFit Select, BonSave, BonComplete, BonClassic and BonComprehensive
✅ This savings options offer sufficient savings to use for medical expenses and extensive hospital cover, with BonComprehensive being a first-class savings plan that offers ample savings, an above threshold benefit and the best hospital cover.
Hospital Plans
✅ You can also opt for hospital plans, that cover them for emergency and planned procedures in hospital and access to some additional benefits for wellness and preventative care.
✅ These options include the Hospital Standard, BonEssential and BonEssential Select plans – the latter using a quality provider network that offers comprehensive hospital benefits and some value-added benefits.
READ more about the 5 Best Hospital Plans under R2000 in South Africa
3. Fedhealth Medical Scheme
👉🏿 Fedhealth has been responsible for the health of South Africans since 1936. Over the years, they have worked diligently to provide affordable, high-quality health care.
👉🏿 The fund has maintained a Global Credit Rating of AA- for fourteen consecutive years, and its reserves exceed the minimum of 25%.
👉🏿 Fedhealth is also well-known for its unique Risk-paid benefits, which enable members maximise their standard benefits.
👉🏿 In an ever-changing world, the company is still run by members for members, and they are constantly developing new methods to assist people take care of their health.
👉🏿 Fedhealth Medical Scheme Option Plans include the following:
👉🏿 Several of the medical aid plans offered by Fedhealth are suitable to fit the needs and budget of pensioners and older people.
👉🏿 The choice will depend on their health situation, available budget and how they prefer to manage their medical expenses.
📌 Notice: Read more about the late joiner penalty of FedHealth Medical Aid
maxima EXEC
Although expensive, the maxima EXEC offers comprehensive all-round cover for older members. Apart from in-hospital, chronic medicine, screening and additional benefits, it has a day-to-day savings portion and Threshold benefit.
maxima PLUS
The maxima PLUS option is the ideal choice for pensioners or people over 65 because it offers extensive medical cover for every aspect of your healthcare, like generous in-hospital cover, chronic medicine, screening and additional benefits, a day-to-day savings portion, a Threshold benefit, and an optional hospital expense benefit.
This option is quite expensive though and can only be considered by pensioners who still have a considerable income to spend on medical aid..
Fedhealth is also known for an excellent scheme that offers you a hospital only plan, but with the benefit of a day-to-day savings fund that you repay only when you spend them. If you want to have access to funds for unforeseen out of hospital costs, but which you can control, this is a very good choice for a medical scheme for people older than 35.
👉🏿 READ more about Health Insurance in South Africa
4. Momentum Health Medical Scheme
☑️ Momentum is one of the most successful open medical plans in South Africa, and it is handled by one of the largest and most reputable healthcare solutions firms in the nation. Momentum is one of the best open medical plans in South Africa. Momentum Health Solutions is held in its entirety by Momentum Metropolitan Life Limited, the parent business of Momentum Health Solutions.
☑️ Momentum Medical Scheme provides its prospective members with a comprehensive selection of medical insurance plans and perks, which includes six different medical aid programmes.
📌 Notice: Read more about the late joiner penalty of Momentum Medical Aid
These plans are:
Evolve Option
👉🏾 This option gives cover for hospitalisation from the Evolve Network of private hospitals with no overall annual limit.
👉🏾 Members who choose this option get access to 2 virtual doctors’ consultations and any additional day-to-day benefits are subject to HealthSaver+.
Custom Option
👉🏾 This option gives members comprehensive hospital and chronic cover from any or associated providers. They can choose to have access to treatment at any hospital or save further on their contributions by using a specific list of private hospitals.
Incentive Option
👉🏾 This top option is suitable those who can afford a more expensive monthly premium. With this option you can get extensive hospital and chronic cover from any or associated providers. Their day-to-day expenses will be covered by a medical savings pocket that is being funded by 10% of their monthly contributions
Extender Option
👉🏾 The Extender Option is more expensive option gives extensive hospital cover and additional chronic cover from any or associated providers, to those who just need an extra bit of coverage. 25% of their contributions go to a dedicated medical savings account from which any day-to-day expenses are paid. They will get the Extended Cover benefit once they have reached their set Threshold.
Summit Option
👉🏾 With the Summit option members can get unlimited private hospital cover from any provider. A chronic cover is available for 36 conditions and day-to-day benefits up to a certain amount per beneficiary per year are also covered.
Ingwe Option
👉🏾 This entry-level medical cover option is the most affordable and accessible to young adults who have just started their first job. They can get treatment from any hospital, the Ingwe Network of private hospitals, or State hospitals. read more about our comparisons for medical aid for young people
Frequently Asked Questions
Are there medical aids with no late joiner penalty?
Unfortunately there are no medical aids in South Africa without no late joiner penalty.
When are you considered a late joiner to a Medical aid?
Under the Medical Schemes Act, those over the age of 35 who were neither dependents or members of a local medical plan prior to April 1, 2001 are eligible for a contribution loading.
How are late joiner penalties calculated?
Late joiner penalties are calculated by a formula which take into consideration the number of years you have been without medical aid coverage and your current age.
Can late joiner penalty be waived?
In some circumstances, a late joiner penalty may be waived or partially reduced if the applicant meets certain extra criteria as set by the spesific medical aid.
When should you join a medical aid and why?
Join a medical aid as soon as possible not only to cover emergency expenditures, but also to avoid late joiner fines later in life.