Open vs Closed medical aid schemes

There are two types of medical aid schemes: open and closed.

An open medical aid scheme is a scheme that is open to the public – anyone can join, regardless of where they work.

A closed medical scheme accepts members from specific defined group of people: an industry, or a specific employer. For example, Gems is a medical aid open only to government employees.

Open medical aid schemes

An open medical aid cannot refuse you cover, regardless of your medical history. It also cannot discontinue cover, except for non-payment of premiums or fraud.

A scheme is also not allowed to charge you a different (higher) premium because of your past medical history.

A scheme, can, however impose waiting periods and late joiner penalties.