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Medical Schemes Act

The Medical Schemes Act No 131 of 1998 has made the following changes to medical aid schemes:

  • There must be standard-rate fees for people to join medical aid schemes regardless of their health or age
  • There can be no discrimination on grounds of peoples’ health, for example, refusing to allow a person to join a medical aid scheme because they are hiv-positive, or because they have asthma or diabetes
  • The definition of dependants includes spouses (husband or wife) and natural and adopted children

This means that people living with HIV or AIDS can no longer be turned away from medical aid schemes on grounds of their medical condition. The minimum medical benefits included for HIV-related illnesses include hospital admissions as well as necessary medical treatment. The treatment for people with AIDS-related illnesses also continues until death.

The Act also sets out a complaints procedure for people who have a complaint against a medical aid scheme.

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