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Who can be a dependant on my medical scheme?

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There are strict rules regarding who can be a dependant on your medical aid.
There are strict rules regarding who can be a dependant on your medical aid.

Every principal scheme member has the right to register dependants, some of them at reduced rates. So who can and can't you register?

If you are the principal (main) member of your medical scheme, you may register dependants, who will also be beneficiaries on your scheme. On some options and schemes, beneficiaries pay a reduced rate. Adult dependants usually pay more than child dependants.

Who qualifies for this?

Children. Your children under the age of 21. This includes biological children and adopted children and stepchildren up to the age of 21 while they are still dependant on you. Not necessarily foster children, though, unless your scheme makes provision for it.

A child of 20, who has started working for a salary, cannot register as a child dependant on your scheme. Child dependants typically pay a much lower contribution than adult dependants. Children with physical or mental impairments, who are dependent on you, can be kept as dependants on your scheme after the age of 21.

However, some schemes may insist they pay the adult dependant rate. The same goes for your children who are full-time students and wholly supported by you. Generally grandchildren can only be added if they have been legally adopted by the grandparents, or a court has granted guardianship to the grandparents.

If a single parent dies, the eldest child will become the principal member of the medical scheme, if they wish to continue their membership. 

A spouse or life partner

If you are not married to this person, an affidavit confirming your relationship must be handed in to the medical scheme. An ex-spouse can be kept as a beneficiary on your medical scheme – this is often determined in divorce cases.

If the principal member dies, the remaining spouse or life partner can become the principal member – even on a closed scheme. These are often linked to a place of work. But the new principal member will not be able to add new dependants.

Your parents

You can only register your parents as adult dependants on your medical scheme if you can prove that they are factually dependent on you. Parents who are financially self-sufficient may not be registered as dependants on your scheme. If you support any of the following people fully, you may apply to register them as an adult dependant on your scheme: parents, parents-in-law, grandparents, step-parents. Once again, individual scheme rules apply.

Other family members

Siblings, half-siblings, nephews and nieces may also be considered for membership (as child or adult dependants, depending on their age) only if you can prove that they are fully financially dependent on you. This depends on the rules of the scheme as well as the individual option you have chosen.

Some schemes restrict dependants to immediate family members (your spouse and children if you are married, and your parents if you are not) and others are more accommodating. It must be remembered that a scheme will be sceptical if you claim to fully support a large number of adults on a single salary.

In many cases, an adult dependant pays the same contribution as a principal member, so if the scheme is an open one, they may as well join in their own capacity. Only some schemes and some options have reduced rates for an adult dependant. 

Sources:

1. The Council for Medical Schemes

2. GEMS Medical Scheme

3. Genesis Medical Scheme

4. Discovery Medical Scheme

5. Medicalaidcomparisons.co.za

Image credit: iStock

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