Medical aid questions to ask before switching employers

By Athenkosi Sawutana

Taking on a new job can be extremely exciting with its new possibilities and probably better pay. However, it can have implications on your medical aid.

How easy or difficult this switchover will be will depend on the type of medical scheme you belong to and whether your employer provides medical aid or not.

Before you change jobs, ensure that the following questions are answered:

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Is your medical scheme closed or open?

When your employer’s medical scheme covers you, there is a high probability that it’s a closed medical aid scheme.

A closed medical scheme is open to workers of a specific company or workers who belong to a certain trade union or have particular academic qualifications.

“If you belong to a closed medical scheme and change jobs, you may have to leave your medical scheme,” says Elmarie Jensen, spokesperson for Genesis Medical Aid Scheme.

For example, if you work for Pick n Pay, you may belong to its closed medical scheme. If you resign and join another employer, you will no longer be able to belong to the Pick n Pay medical scheme.

Another example pertains to civil servants. If a civil servant changes jobs, it will not affect their medical aid because civil servants belong to the same medical scheme. However, if a civil servant decides to join the private sector, he or she will no longer be covered under their old medical aid.

If your new employer has a different medical aid provider, you will need to resign from your existing scheme before joining the new scheme, says Julie Keenan, spokesperson for FedHealth.

However, if you belong to an open medical scheme and change jobs, there is no need to withdraw, unless membership of a specific open medical scheme is a condition of employment with your new employer, says Jensen.

An open medical aid scheme is one that is open to the general public.

Let us say you work for a corporate and belong to an open scheme and then become a stay-at-home parent, your membership with that scheme can continue. The only condition would be that your monthly membership contributions must be paid, either by your employer or by yourself or any other person.

If you belong to an open medical scheme where you pay your monthly contributions and then join a new employer that will pay your monthly contribution, you must make the necessary payment arrangements with your medical scheme, advises Jensen.

While waiting for your new employer to take over your medical aid contributions, you must always keep your medical scheme updated and not miss any monthly contributions, advises Jensen.

Your membership may be suspended or terminated if payment is not received on time.

Does the new employer provide medical aid?

You also need to check if your new employer provides a medical aid benefit. Some employers don’t, or they pay a smaller contribution towards your medical aid. If the employer’s contribution is not enough, you’ll have to carry the cost yourself.

Alternatively, you can choose a medical plan that you can afford. A hospital plan is more affordable than medical aid, but it does not cover everything that a medical aid covers.

How long will it take to transfer your medical aid?

According to Keenan, medical aid cover can easily be transferred if your new employer offers cover from the same medical aid as your current employer.

Even if you have to down- or upgrade to a new option, this is quite a straightforward process as long as you stay within the same scheme.

However, changing from one medical scheme to another could mean that you have a few months without medical cover. Your new employer may take time to get your new medical aid in place. Unfortunately, it’s illegal for a person to belong to two medical schemes at the same time. But you use your medical insurance (if you have it in place) in the interim.

READ MORE: Switching medical aids – what you need to know

Moreover, if you switch your medical schemes, you can expect to wait for a certain period before you’re allowed to use your medical aid. By law, medical schemes have a right to impose a three-month waiting period or 12 months for specific conditions.

“It’s important to ensure that you don’t have a long break in medical aid cover, as you might be penalised by the new scheme with later joiner penalties or waiting periods,” says Keenan.

Later joiner penalties usually apply to people who are over the age of 35 and haven’t belonged to a medical aid for a particular time.

If you give notice to your old scheme at the same time you give notice to your current employer, this will allow for enough time to get your new medical aid in place before you start at your new employer, says Keenan.

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