Question: When can I change my medical aid plan?

Need a new plan? Determining when you can change your medical plan depends on whether you want to stay with the same scheme or not.
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Changing plans at the wrong time, or to the wrong plan can have disastrous effects on your cover. You should always speak to a professional advisor before making any such changes. Appointing a broker is always free of charge.

Determining when you can change your medical plan depends on whether you want to stay with the same scheme or not.

Staying with the same scheme

If you want to change plans, but not schemes, you can always do that at the end of the year, to start from January of the following year. Confirm deadlines with your scheme.

Most schemes will allow you to downgrade your plan at any time, although there are exceptions.

Some schemes might allow you to upgrade your plan at any time. Speak to them directly.

Some schemes will allow you to upgrade your plan to a higher plan in the middle of the year if you have been diagnosed with a life changing condition that requires better coverage (for example, Bestmed will allow you to upgrade your plan if you have been diagnosed with cancer, and your current plan only allows treatment in State hospitals). Some schemes will place a time limit on this upgrade (for example, you need to change plans within 30 days of a new diagnosis).

Changing schemes

If you want to change schemes, you can do so at any time.

You cannot be a member of two medical schemes, so you need to time your change carefully: you need to resign from one scheme the day you become a member of the new scheme.

Note your scheme’s notice period. Most schemes have a 30 day notice period.

What else should I know?

  • If your current plan has a savings fund, and you change plans in the middle of the year, your scheme will calculate how much savings you were entitled to on a pro-rata basis. If you have used less than this, they will refund you or transfer to your new plan. If you have used more, you will need to pay it back.
  • If you change plans in the middle of the year to one that has limits on benefits, know that those limits will be worked out on a pro rata basis for the year. For example, if you join mid-year, and a benefit usually has a annual limit of R5,000, only half of that will be available to you for the remainder of the year.
  • When changing plans, be aware of waiting periods. This is crucial, as a mistake here can cost you dearly. Always speak to your broker if you think you are going to have waiting periods applied.

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