Because of the new year and many new clients join Medical Aids or even just move over to diffrent Medical Aid schemes. It is important to understand how Medical Aids handle underwriting on waiting periods.
Here are a few underwriting basics:
First of all as soon as a client decides to take out a new medical aid or move from their current medical aid over to a new one, CareLine Group need all previous medical aid cover to insure the client gets the correct underwriting.
CareLine Group will submit the cover with the application and the underwriters will process it and make a decision. They will look at how many years you belonged to a scheme and work according to that.
There are 3 types of clients:
“A” client is a new applicant with a break from a scheme more than 90 days. A clients will receive a 3 month general waiting period, 12 month condition specific waiting periods on all conditions treated for a year back from date of application. “A” clients unfortunately does not have PMB (prescribed minimum benefits) cover.
“B” clients are members who have belonged to a medical aid for 0-24 months without a break longer than 90 days. “B” clients will not get a 3 month general waiting period but will receive 12 month condition specific waiting periods for all current conditions. PMB cover will be given to a “B” client.
“C” clients are members that have belonged to a medical aid longer than 24 months without a break longer than 90 days. “C” clients will receive a 3 month general waiting period but no 12 month condition specific waiting periods. PMB cover will be given for a “C” client.
The reason these waiting periods were implemented are to protect the funds of the Medical Aid Scheme.
CareLine Group will take the time to assist any new joiners to Medical Aid or current Medical Aid client in looking if waiting periods may apply to you. Contact CareLine Group on 0861 45 00 45 or compete our Contact Us form and we will get back to you.