Medical scheme dependants: who qualifies?

In terms of the Medical Schemes Act, no medical scheme may refuse to admit persons who are dependent on the member.

Among those who qualify as dependants are  the following:
  • the member's spouse or life partner
  • children under the age of 21
  • children older than age 21 dependent upon the member due to a mental or physical disability
  • children still financially dependent on the member (such as a full-time student)
  • immediate family in respect of whom the member is legally liable for family care and support
  • such other persons who are recognised by the scheme as dependants
Depending on your scheme, adult members  will usually pay substantially more than child dependants. Many schemes will only charge for the first two or three child dependants – after that membership is free in some instances. If you have more than three children, it will pay you to shop around.

Read more: 10 tips on choosing a medical scheme

Ex-spouses can usually be registered as members on your scheme – provided legal provision has been made for this in the divorce court.

Immediate family is classified as the mother or father of the member. The scheme concerned may require proof of such financial dependency and appropriate additional contributions in respect of such extended cover must be expected.

You may not register family members over 21 who are not financially dependent on you. Schemes can charge an adult dependant the rate usually paid by a principal member.

A minor can become a principal member of a medical scheme with the assistance of his parents or guardian, provided that the relevant contributions are paid.

If a member dies, his registered dependants will still be covered, provided contributions are paid. One of the dependants, usually the remaining spouse or the eldest child, will become the new principal member.

(Source: Council for Medical Schemes)

Read more:
20 claims schemes will not pay
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