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Medical Aid for Child Only – Medical Schemes

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Medical Aid Schemes Provide Cover for a Child Only?

Enquiries regarding medical aid membership for a child only have become increasingly common and there are a variety of reasons for this trend. For example, the alarmingly high divorce rate that is now the norm in South Africa has left many children in the care of a single parent who may have affordability issues or a new partner or step-parent who is unwilling to meet the cost. While these are certainly compelling reasons for the nation’s healthcare insurers to offer this type of service, the existing regulations governing their operations do not currently permit them to do so.

Membership for a single individual is a valid option, but the minimum age requirement is 18 and this explains why medical aid for a child only is not actually possible in terms of the existing legislation. This, of course, does not exclude the possibility that the law could, at a later stage, be changed in order to accommodate what is clearly a growing and important need. However, in the interim, in order to obtain private healthcare cover for a minor, he or she will need to be included under the scheme of a main member.

It is not just divorce that has fuelled this need and both the high incidence of violent crime and the HIV/AIDS epidemic have left many children orphaned and forced to prevail upon their aunts, uncles or grandparents to support them. In such cases, medical aid for a child only can sometimes be possible. Where he or she was originally included under a parent’s membership and that parent has since passed away, the membership of a minor dependent will, nevertheless, remain valid as long as the premium payments are maintained and the main member will simply be registered as deceased. This will, however, be unlikely to result in a premium reduction, even though the death of the main member reduces the risk to the cover provider.

Divorce creates its own financial problems and, where parents remain bitter and uncooperative, the needs of their children can sometimes become a secondary concern.  Because one cannot otherwise obtain medical aid for a child only and cover is still important to safeguard their health, one possible solution is to approach another adult family member and request that the minor child is included under his or her membership. The additional premium applicable in such circumstances is likely to be quite modest and should prove to be less of a strain for a parent to contribute. It could even be shared between them once their mutual hostility has subsided.

Under the terms of a scheme dependent, children are permitted to maintain this status until they reach the age of 26. This means that although this is not exactly what amounts to a medical aid for a child only, his or her cover will extend throughout the varsity years and early employment, and will be subject only to the routine premium increases approved by the CMS and not by the dependent child’s age. Another affordable option for over-18s is the hospital plan, which covers emergencies and high hospitalisation costs for those of sound basic health.

At KeyHealth, we are bound by prevailing membership regulations, but we can offer affordable alternatives to medical aid for a child only.

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