Medical Aid Waiting Periods in South Africa: What You Need to Know

What Are Medical Aid Waiting Periods?

Waiting periods are the time after joining during which certain benefits are restricted. There are two types:

1. General Waiting Period (3 Months)

All new members face a 3-month general waiting period. During this time, you are not covered for any claims — except PMB emergencies.

2. Condition-Specific Waiting Period (12 Months)

If you have a pre-existing condition, you may face a 12-month waiting period for treatment related to that condition.

⏰ Don't wait until you need cover

The sooner you join, the sooner your waiting periods are behind you.

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How to Avoid Waiting Periods

Switch from another scheme — Direct transfer with no gap waives waiting periods

Maintain continuous cover — Never let your medical aid lapse

Join before age 35 — Avoids late-joiner penalties on top of waiting periods

What's Still Covered During Waiting Periods?

Even during your waiting period, your medical aid must cover PMBs for:

Medical emergencies — heart attacks, strokes, accidents

27 chronic conditions — including diabetes, hypertension, HIV/AIDS

270+ PMB conditions — serious diagnoses requiring hospitalisation

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