Medical aid cover is open to a person who has been diagnosed as HIV positive and in most instances, there is no additional cost for the benefits. Most medical aids in South Africa do have strict exclusion policies where any pre-existing chronic condition will not be covered in the first year of joining the medical aid – the same may apply for HIV/AIDS. However, after this exclusion period, you will enjoy the full benefits of medical aid cover with special programs for HIV/AIDS patients ensuring that you get the best care.
Medical aids usually do not cover any procedure or treatment for a pre-existing condition within the first year of joining a scheme. This applies to pregnancy as well and almost all medical aid schemes will not cover the pregnancy and delivery costs for a new member who joins the scheme when pregnant. While it may be argued that pregnancy is a normal physiological process and not a disease, medical aids have to weigh out the risks associated with covering a person compared to the total contributions. There has been a trend in South Africa for pregnant women to join a medical aid, stay on it throughout pregnancy and a month or two after childbirth, only to then leave the scheme. The total payout for pregnancy and childbirth costs may be more than the member’s total contributions meaning that the scheme has to fund these costs from the pool..