Age limits are an important consideration for hospital plans because depending on what you may be looking at for cover, you may be too young or too old. It ultimately depends on the type of hospital plan you are looking at. In South Africa, the term hospital plan is used so frequently but very few people understand that it is an umbrella term which refers to different financial products, namely medical aid and a hospital cash back plan. Similarly the minimum and maximum age criteria and limits for cover varies according to each type of hospital plan. Here is a quick overview :
- Any person of any age can join a medical aid.
- A hospital cash back plan is only open to people under the age of 65 years.
Age for Medical Aid Hospital Plans
As stated above, a medical aid does not discriminate on age when it comes to membership. There is no maximum age just like there is no minimum age. Any person of any age can join a medical aid and stay on it for life, or for as long as they can afford to stay on it. However, medical aids require that the main member is at least 18 years old. All other dependants can be of any age. There are instances, like in divorce, where parents seek a medical aid only for children but this is unfortunately not allowed without a main member being 18 years or older. Medical aid hospital plan only cover does not end at any specific age. Even the golden 65 years is not a limiting factor and your premiums will not increase because you are now a senior citizen.
Late Joiner Penalty
However, age does play one important role when it comes to medical aids and that is if you join a scheme after the age of 35 years. Medical aids penalise members who join up when they are older than 35 years and this is known as a late joiner penalty. It is part of your monthly contribution for life. The fact is the older you get, the more likely you are to need a greater level of medical care. Joining a medical aid later in life means you will drain more resources without having contributed in your younger and healthier years of life. Therefore the late joiner penalty makes up for this age when you sign up for medical aid.
Age for Hospital Cash Plans
Cover after 65 years
A hospital cash back plan will cover any person who is under the age of 65 years. Remember that these cash plans are insurance policies with cash benefits. It is not a medical aid and is therefore not bound by the relevant legislation to cover every person of any age and health status. The unfortunate part is that people in their senior years are more likely to be unwell to the degree that they require hospitalisation. Furthermore, the senior years after retirement is a tough financial time in life. This is where seniors could benefit the most from cash payouts for being in hospital but unfortunately do not qualify for cover any longer after 65 years.
What happens for 18 year olds?
Although the maximum age of 65 years stands for hospital cash back plans, but not medical aids, both have the same maximum age when it comes to being a child dependent on not. This means that if you are on your parent’s medical aid or hospital cash back plan, then your cover will fall away once you turn 18 years. If you can prove that you are a student and therefore still a dependent of your parent, then you may remain covered under their medical aid hospital plan, usually not exceeding 21 years of age. However, this age cut off does not mean you cannot enjoy cover. Since you have passed the minimum age of 18 years, you can have cover on your own if you can afford to pay for it.