Dealing With Waiting Periods for Hospital Plans

Waiting periods for hospital plans irritate people. You have to serve these waiting periods when you start a new medical aid or you are looking to increase your level of cover. Many people only find out about these waiting periods when they want to put in a claim. Never believe that as a first timer with a hospital plan, your cover starts immediately.

Waiting Periods for Hospital Plans are a Form of Protection

People can’t understand why, when they are paying a premium, they don’t get cover for a specific period. Waiting periods for hospital plans mean you are not covered in that time. And it is only in some exceptional cases, where these waiting periods don’t apply.

The reason why these waiting periods exist is that they protect the current membership pool from abuse. Medical aids and hospital plans offer protection from people who just join medical aids or hospital plans when they find they suddenly need medical attention. They cancel their membership soon after joining.

These waiting periods protect members of the fund by making sure that people can’t just join, benefit and then quit. It is this kind of action which results in increased premiums for all the current members.

Understand the Different Waiting Periods for Hospital Plans

Dealing With Waiting Periods for Hospital PlansThe thing with waiting periods for hospital plans is that they aren’t always imposed when joining a medical scheme, but rather at their discretion. You get 2 types of waiting periods – general and condition-specific waiting periods.

A general waiting period lasts for 3 months. That is assuming members pay their regular monthly contributions. In this time they may not claim any benefits.

Condition-specific waiting periods  can last up to 12 months. Members pay their monthly contributions, but the cover excludes any pre-existing health condition. The member pays any and medical costs in this period.  These pre-existing conditions are those illnesses or conditions you had before joining a medical scheme.

To recap: all medical aids as well as insurance companies and hospital plans have waiting periods. These last from between 3 – 12 months. With a medical aid there is a 3 month general waiting period. However,if you have a pre-existing illness, you won’t have cover for this particular illness for up to 12 months.

Hospital plans are available in different varieties and you need to establish if your one will pay out from day 1 or only from day 3. Hospital cash back plans are insurance policies that pay you for each day you are in hospital. And there is also a waiting period, applying to the first 6 to 12 months of cover.

Get a Hospital Plan WELL before you become Pregnant

There is also a waiting period with obstetrics. Many women become alarmed when they hear that they are pregnant but that there is also a waiting period when they join a medical scheme. If you are planning to become pregnant and wish to be covered, the idea is to organise appropriate health insurance well in advance of you becoming pregnant. You need to remember too that some less expensive hospital plans don’t include obstetrics, or they may only pay restricted benefits in a public hospital. Waiting periods are there for a reason – they simply protect you from those people who join medical aids for financial gain, leaving the loyal, in-it-for-the-long-term customers with increased premiums.


All info was correct at time of publishing