Late-Joiner Penalty

The Medical Scheme Act instructs medical schemes to charge a late-joiner penalty if someone joins a medical scheme for the first time when they're 35 years or older, or if someone is a member of a medical scheme and has a break in coverage for more than 3 months then wishes to join a medical scheme again.

The Act calls this person a 'late joiner'. This does not apply to members or their dependants who were members of a medical scheme before 1 April 2001 and who have not had a break in coverage for more than three months consecutively.

The Board of Trustees can decide to charge a late joiner an extra percentage of their contribution, depending on how long they have not been a member of a medical scheme. The penalty is permanent and will apply for the duration of the membership.

Penalty bands Maximum penalty
1 to 4 uncovered years 5%
5 to 14 uncovered years 25%
15 to 24 uncovered years 50%
25+ uncovered years 75%

If you can prove that you've been a member of a South African medical scheme before, we subtract the years of membership from your current age when we work out your late-joiner penalty.