There are instances where children may need to be on a medical aid on their own, without parents or other adult members. This is often seen in divorce where the person paying maintenance, usually the father, wants to cover their child or children but not their ex spouse. Nor does the father want to include the child on his medical aid. Unfortunately this is a problem because a child cannot be the main member of a medical aid. It poses a dilemma and other options have to be explored.

Medical Aid for Children Alone

The main member of a medical aid has to be at least 18 years old and then other adult and child dependants can also be on the same cover. The only time when this rule is somewhat “bent” is in the event of death where the main member is then listed as deceased. However, in this case the main member had taken out the medical aid while they were alive and added other adult and child dependants to the cover.

The problem arises when you look at starting a new medical aid with only children. If any of the children are over 18 years of age then he or she can serve as the main member. Otherwise some other adult will have to stand as the main member and the children as dependants. Medical aid rules change quite frequently so while this rule may stand today, it could change by tomorrow. It is therefore important to speak to a medical aid broker.

Medical Aid After Divorce

Single parents, be it after divorce or where a couple did not marry but live apart, are often faced with this issue. On one hand the father or mother who is paying maintenance is held liable for the child’s medical bills. But on the other hand the maintenance payer is not prepared to take the child on their medical aid or be part of a medical aid. Neither is the maintenance payer prepared to pay for a medical aid where the parent with custody is a member.

Sometimes it may not be an option if the parent with custody has now married again and is on a separate medical aid with their new spouse, and the step-parent is not prepared to include the child in his/her cover. It is a difficult situation but it can be resolved if parents of the child are able to negotiate at some point. At the end of the day medical aid cover is for the child’s benefit. Being petty and letting the power struggle then compromise the child’s health care needs only affects the child at the end of the day.

There are one of two options that has to be considered – either one of the parents take the child on their medical aid, or if possible an adult relative (like a grandparent) take the child on their medical aid. The parent who is paying maintenance therefore has to only contribute the child’s fee as part of the maintenance agreement. The bottom line is that a minor cannot start up on a medical aid alone.

Type of Medical Aid for Children

There are some considerations that should be borne in mind when selecting a medical that is there primarily to serve a child’s needs. Do you take out a full medical aid with day-to-day benefit or do you settle for a hospital plan only? A full medical aid is more expensive but a hospital plan pays for the most expensive services which are in a hospital setting.

Remember that if you are paying maintenance then you may be liable for the day-to-day medical expenses of the child. Settling for a hospital plan may cost you every month in terms of medical aid premiums but when the child has to see a doctor or need other services out of hospital then you may still need to fork out money.

Given that children get sick so often it may be more worthwhile to commit to a full medical aid at the outset with comprehensive day to day benefits. A medical aid hospital plan is not ideal and a hospital cash plan will not do as it is not a medical aid. You may want to look at the new medical insurance or health insurance plans but these are not medical aids. There is no single solution that works for every instance. Ultimately the decision is up to the parents and sometimes even the courts.

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