What is the Waiting Period for Discovery Medical Aid?

As a South Africa, one of the things that you should do is to sign up for medical aid. It’s essential to do so in case you and your loved ones fall sick. Without medical cover, you will need to fork out money from your pocket. If you’re new to Discovery Medical Aid or switching from another medical scheme, you might be wondering what their waiting period is. In this post, we will answer the question, what is the waiting period for Discovery medical aid?

How long is the waiting period for discovery medical aid

The waiting period for Discovery medical aid is 3 months, 6 months, or 12 months, depending on your scheme and other factors. The general waiting period is 3 months, but a longer waiting period of 6 or 12 months can be imposed on specific conditions.

What is a medical aid waiting period?

The waiting period is a specified time frame during which your medical aid scheme won’t cover certain medical expenses. This applies to new members or those who’ve recently upgraded their plan.

You may be wondering why medical aid companies and other insurance companies apply waiting periods. The answer is simple enough. Without a waiting period, a lot of people would simply join insurance in order to have their issue solved.

Let’s say someone falls sick. If they are allowed to immediately start benefiting after joining a medical aid, that would be a disservice to other people. Long paying members of the medical aid society would then need to cover that person.

That’s the reason why there are waiting periods. It’s to prevent insurance fraud. When you join a medical aid scheme, you need to wait the specified period before you can claim. But why are some waiting periods longer?

Generally, for types of treatment that cost a lot of money, the waiting period tends to be longer. There are some treatments out there that can run into the millions when it comes to being treatment. In that case, you will need to wait longer before you are covered.

Types of Waiting Periods for Discovery Medical Aid

There are two types of waiting periods:

• General Waiting Period (GWP): This applies to all new members and lasts for 3 months. During this time, you can’t claim for any medical expenses except for:
  • Prescribed Minimum Benefits (PMBs)
  • Emergency situations
• Condition-Specific Waiting Period (CSWP): This applies to specific medical conditions that existed before you joined Discovery Medical Aid. The waiting period can be 6 or 12 months, depending on the condition.

How Does it Work?

Here’s an example:

• You join Discovery Medical Aid on 1 February 2024.
• You have a general waiting period of 3 months (February, March, and April).
• During this time, you can’t claim for non-emergency medical expenses.
• After the waiting period, you can claim for all medical expenses, including PMBs.

Exemptions and Exceptions

Some medical expenses are exempt from the waiting period:

• PMBs (as mentioned earlier)
• Emergency situations
• Maternity and childcare benefits
• Certain chronic conditions (listed in the Medical Schemes Act)

Tips and Reminders

• Always check your scheme’s rules and waiting periods before joining or upgrading.
• Keep your medical expenses records handy to ensure smooth claims processing.
• Don’t hesitate to contact Discovery Medical Aid’s customer service if you have questions or concerns.

Plan ahead

In this article, we focused on the question, “what is the waiting period for Discovery medical aid?” We noted that that depends on the type of service that you wish to get and on other circumstances.

The waiting period might seem like a hurdle, but it’s an essential aspect of medical aid schemes. By understanding the waiting period and its exemptions, you can plan your medical expenses and make the most of your Discovery Medical Aid membership.

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