Whilst on the one hand individuals are checking with their medical aids and financial advisers to see if they are covered for COVID-19, other cash strapped ones are concerned about being able to afford their medical aid premiums at the end of the month.
In a recent media release, GTC discusses the question many individuals may have: Can I freeze my medical aid contributions because of financial strain during COVID-19 lockdown?
“Medical Aid contributions are certainly one of the biggest monthly budgeted expenses for most households,” says Zee Gumede, senior healthcare consultant at leading wealth and financial advisory firm, GTC. “As a consequence, members are looking for every opportunity to cut or reduce this expense. They want to know how this will affect their benefit levels, how quickly changes can be made and what would happen if they have to cancel their medical aid altogether – hopefully with the option to re-join at a later stage, once finances allow.”
The Medical Schemes Act, in Chapter 5, Section 29 (2) confirms that “A medical scheme shall not cancel or suspend a member’s membership or that of any of his or her dependents, except on the grounds of – (a) Failure to pay, within the time allowed in the medical scheme’s rules, the membership fees required in such rules.”
In addition, the Council for Medical Schemes Circular 25 of 2020 addresses non-payment of medical aid premiums and asks that all Medical Aids, investigate all disruptions to member contributions on a case by case basis and determine the merits thereof, prior to termination.
However, Gumede points out that dealing with defaulters individually might add to administration complications in the current working environment and that the non-payment of premiums will also impact the medical scheme community. Discovery has, for example, confirmed that although they are monitoring the situation, the normal billing process still applies.
Gumede further confirms that the CMS has received proposals from numerous medical schemes, on ways to provide ‘payment holidays’ to members. “Once these proposals are analysed and exceptions granted, further relief options will be released,” she remarks.
Zee Gumede outlines some recommendations and considerations for individuals battling to pay their medical aid contributions.
