| MAIN MEMBER | ADULT DEPENDANT | CHILD DEPENDANT |
| R5 106 | R4 984 | R1 528 |
Please note that Employer subsidies that may apply to the above contributions may vary, as this is determined by your conditions of employment and administered accordingly. Queries in this regard should be directed to your Employer. It remains your responsibility, however, to ensure that your monthly contributions are paid in full to the Society.
Definitions:
What waiting periods apply to new members and dependants?
The Act provides for waiting periods to be imposed on new applicants to a medical scheme, and to beneficiaries who move from one scheme to another. There are two different waiting periods:
- A 3-month general waiting period during which no claims will be paid by the Society; and
- A 12-month condition-specific waiting period during which a beneficiary is not entitled to claim benefits in respect of a condition for which medical advice, diagnosis, care or treatment was recommended or received within the 12-month period before you applied to be a member.
Condition-specific waiting periods may not be imposed on related conditions unless a direct link can be demonstrated between the conditions. If an applicant has never belonged to a medical scheme or where the beneficiary had a break in cover of more than 90 days, the waiting periods may also apply to PMB conditions.
What if a beneficiary has not been a member of a medical scheme before?
| Penalty bands | Maximum penalty |
|---|---|
| 1 – 4 years | 0.05 x contribution |
| 5 – 14 years | 0.25 x contribution |
| 15 – 24 years | 0.50 x contribution |
| 25 + years | 0.75 x contribution |
Who qualifies as an adult dependant?
- a member’s spouse or life partner;
- a member’s (natural, step or legally adopted) child who is dependent on the member; and/or
- a member’s immediate family for whom the member is liable for family care and support and is thus dependent on the member, restricted to:- •parents (including adoptive parents)
- siblings (brothers and sisters)
- siblings of a child dependant, if such child dependant has been orphaned or if such child dependant’s remaining parent does not qualify for registration as a member, provided that such siblings were registered as a dependant of the deceased member at the time of the death of the member.
The criteria to prove dependency in terms of Ruling 9 (dependants other than a member’s spouse/partner or a child under the age of 21) of the Society is:
- The dependant should not have a regular monthly income of more than twice the latest published minimum monthly wage of a Shop Assistant in the Retail Industry Area A as published by the Department of Labour;
- The dependant should be able to demonstrate that the dependant is reliant on monetary assistance provided by the member to the dependant to meet reasonable day-to-day living expenses; and/or
- The dependant should be able to demonstrate that the member assists in providing accommodation for the dependant.
IMPORTANT: Dependants who wish to be registered with the Society may not remain a member of another medical scheme or a registered dependant of a member of another medical scheme.
When will the child rate apply to a child dependant?
- under the age of 21; or
- over the age of 21 but under the age of 26 and can prove their dependency as provided for in Ruling 9 of the Society; or
- over the age of 21 but under the age of 26 but due to mental or physical disability is not independent.
When will the adult dependant rate start to apply to a child dependant?
A financially dependent child aged 26 and older may remain a registered dependant, but adult dependant rates will apply.
Note: For more information about late joiner penalties, please refer to the Society’s rules, available from the Society and on this website.