MEDICAL SCHEME TERMINOLOGY

PRINCIPAL MEMBER, DEPENDANTS, AND BENEFICIARIES
The principal member of a Scheme is the main member on a
membership. A principal member usually pays a larger contribution to the Medical Scheme, than what the dependants pay. Any additional
person/s is/are referred to as dependants on the membership. All
principal members and dependants are referred to as beneficiaries of a
Medical Scheme.

ACUTE VS CHRONIC MEDICAL CONDITIONS
Acute medical conditions are conditions with a sudden or severe onset of
symptoms and could include anything from an allergic reaction, flu, headaches and broken bones. Chronic conditions, on the other hand, are conditions that developed over a longer period of time, with symptoms that last more than 3 months or for which ongoing treatment is required.

EXCLUSIONS
Medical Schemes may exclude some medical conditions and procedures, for example self-inflicted injuries, cosmetic surgery to name but a few. It is a member/beneficiary’s responsibility to confirm with a Medical Scheme to ensure that a procedure or treatment that they will be having will be covered and is not an exclusion. Our team is there to assist you in interpreting the Scheme’s rules.