Legally, the answer to this oft-asked question is a definite “No”, because it is against the law in South Africa. On the other hand, it is not impossible that one person may be registered as a member with more than one medical scheme, which is why the original question arises in the first place.
Changing Jobs or Employers
It may happen that you have been a member of a particular medical scheme to which your existing employer subscribes, and now you’re just about to join a new company that uses a different medical aid service provider. During the transition period, your membership of medical scheme A may overlap that of scheme B, but this should only be very brief and temporary.
The Self-Payment Gap and Threshold
By far, most medical aid plans, other than those that are the most expensive and comprehensive, have certain exclusions, co-payments, or levies and limits attached to their coverage or claims procedures. Then, there’s the well-known self-payment gap too, the period during which you’re required to pay claims out of your own pocket when your medical savings account is depleted and above-threshold benefits have not yet been reached.
Taking the Gap – Illegally
Therefore, people might be tempted to retain membership of one scheme, join a second, and fund claims from the second scheme’s benefits when the medical savings account of the first scheme runs out, or reaches the self-payment gap. Beware, because this is illegal and fraudulent. You might get away with it for a short while, but the law will catch up with you, in a big way. When applying for medical aid membership, each and every scheme in South Africa asks whether the person is currently or has been a member of another scheme, and which it is, the person’s membership number, and the duration of the applicant’s membership.
The purpose of this step is the prevention of possible or accidental dual or multiple memberships, which is, as mentioned before, illegal. Failure to answer this question honestly, and simultaneously belonging to more than one or multiple medical schemes is not only illegal, but because it is fraudulent, you leave yourself open to criminal prosecution if you don’t comply with the conditions of the relevant medical schemes act’s stipulations in this regard. The law is clear – no simultaneous, permanent dual medical scheme membership is permitted.
An Employee Benefit
In the not-too-distant past, medical aid membership was restricted to persons working for most bigger companies in this country. Medical scheme membership was (and still is) an employee benefit, because the employer usually subsidises the member’s monthly contribution. People who worked independently, outside such corporate organisations, seldom had access to a medical scheme unless they belonged to a recognised profession, for which there were separate schemes that they might join.
A New Scenario
Fortunately, the medical aid scenario has changed; private membership is commonplace and very popular, and a group scheme is no longer one’s only option. It’s a big advantage to be able to belong to a medical scheme privately, because you’re not excluded from membership and its benefits, while you’re in a position to choose a scheme that suits you, your needs and your pocket – ideally a transparent scheme like KeyHealth.
