Answer: If you leave your medical aid and want to join again in the future, the medical aid has the right to impose waiting periods when it comes to covering certain medical conditions that you may have at that time. You run the risk of not having cover for certain conditions for a period of as long as a year.

This is a big decision and there are a number of things that you should consider.

Is your medical aid really too expensive? While the premiums for a medical aid may be high, the impact on your finances should a claim occur and you don’t have the cover could be devastating.

A family member of mine had a four-month stay in hospital. The various hospital and doctors’ bills, which the medical aid covered, were significantly more than the premiums paid.

You do have the option of using the state’s medical facilities. The downside here is that there are often long queues. The time spent in queues can have a financial impact, especially if you work for yourself.

Instead of leaving your medical aid, an option that you could rather consider is to downgrade to a lower plan within your medical aid. Each medical aid has several options that you can choose from. These options offer more comprehensive cover and may cover the medical bills to a higher multiple of the standard rates.

You are allowed to downgrade your medical cover at any stage during the year. This should result in a lower premium. You will, however, only be allowed to upgrade your cover once a year on the medical aid anniversary date.

I would recommend that you have a chat to a financial adviser who specialises in medical aids. They often have computer packages which list all the benefits under each medical option, and you should be able to find the sweet spot where you have sufficient cover at a more affordable rate. The advantage here is that when you want to upgrade your cover in the future on the anniversary date, there will be no waiting periods applied.

Insider tip

A hospital plan typically covers you at a standard rate. However, many doctors charge quite a bit more than this rate. You should therefore also consider taking out gap cover, which typically covers the gap between what the hospital and doctors charge for your treatment and what a medical aid pays. This cover is not that expensive.

To summarise, be careful about leaving your medical aid, as it is not always that easy to rejoin without having conditions imposed. Rather explore the option of downgrading to a hospital plan and taking out gap cover. DM168

Kenny Meiring is an independent financial adviser. Contact him on 082 856 0348 or at financialwellnesscoach.co.za. Send your questions to [email protected].

This story first appeared in our weekly Daily Maverick 168 newspaper, which is available countrywide for R29.