FREQUENTLY ASKED QUESTIONS:

MORE ABOUT THE AECI MEDICAL AID SOCIETY

Who manages the Society?

  • The Society is a separate legal entity managed by a Board of Trustees consisting of member elected Trustees and Employer appointed Trustees.
  • The Administrators’ services are contracted out to Medscheme Pty Ltd for all options, as well as the Managed Care services.

What is the difference between GPs, specialists and auxiliary service providers?

  • A General Practitioner (GP) is someone who completed the standard training for a medical doctor.
  • A Specialist is someone who has completed advanced education and clinical training in a specific area of medicine (their specialty area), for example, paediatrician, gynaecologist, cardiology, neurology, and so on.
  • Auxiliary services providers are generally not doctors, but trained in a specific field. Examples are audiologists, physiotherapists, dietitians and chiropractors.

What do I do in a medical emergency?

  • Call Netcare on 082 911 and tell the Netcare operator that you are an AECI Medical Aid Society member.

What is a Scheme Tariff?

  • The Scheme Tariff is the reimbursement rate that the Society uses to pay for medical services.

What services and procedures are NOT covered by the Scheme?

  • All medical schemes have to make sure that the members’ money is used for genuine medical reasons. For a comprehensive list of exclusions, refer to member brochure.

MEMBERSHIP

Will there be waiting periods if I join AECI Medical Aid Society?

  • No waiting periods or pre-existing exclusions will be applied if you join the Society from date of employment.
  • No waiting periods or exclusions will be applied if you belonged to another Medical Schemes for a period not shorter than 24 months and you transfer to the Society without a break of more than 90 days.
  • Waiting periods and/or pre-existing exclusions may be applied if you or your dependants join the Society more than 90 days after start of employment and have no current medical cover.

Can anyone join AECI Medical Aid Society?

  • No, the Society is not open to the public. The Scheme is exclusively for employees of the participating company and its pensioners.

Can my parents be registered as my dependants on the Society?

  • No, in accordance with the rules of the Society parents of members cannot be registered as dependants.

Who can be registered as my dependants on the Society?

  • Spouse/partner.
  • Biological or Adopted children.
  • Court appointed foster child.
  • Stepchildren providing that no other court order is in place stipulating responsible party.
  • Siblings of main member only, if orphaned and member is court appointed legal guardian Maximum age of 21.
  • Grandchildren providing that the mother/father is a registered dependant on the main member’s medical aid or main member is the court appointed legal guardian. Maximum age of 21.

How do I register dependants on my membership?

  • The application forms must be completed for registration of dependants, please contact your HR department or Medscheme on 086 000 2103 for assistance.

Can my spouse remain as a dependant after a divorce?

  • No, divorced spouses are not allowed to remain as dependants on the Society and no court can force membership on a closed medical scheme.

Until what age can my children be dependants on my membership?

  • Up to the maximum age of 25 providing that they are full time student or financially dependent on the main member.

What contribution rate is applicable for my adult child dependant?

  • Adult rates are applicable to child dependants in the month after they have turned 21.

Do I have to belong to AECI Medical Aid Society whilst in the employment of the participating company?

  • Membership of the Society is a condition of employment unless you are a registered dependant on your Spouse/partner’s medical aid.

Can I belong to more than one medical aid?

  • No, in accordance with the medical schemes act any one person can only belong to one medical aid at any given time as a main member and/or dependant.

Can I continue membership after terminating my employment?

  • No, only active employees or employees who have become pensioners of the participating company are allowed to be members of AECI Medical Aid Society.

Can I change options any time?

  • No, you can only change options from 01 January each year.

What is the benefit year of the Society?

  • The benefit year is from 01 January up to 31 December.

BENEFITS

Can I transfer funds from one benefit that I don’t use? For example: maternity to acute medication?

  • No, as per the Medical Schemes act and the rules of the Society benefit funds transfer is not allowed.

Can I use funds available for one beneficiary for another beneficiary? For example, optometry?

  • No, benefits are not transferrable between beneficiaries on your membership

COMPLAINTS PROCEDURE

What do I do if I have a complaint against the Society?

  • If you cannot resolve your complaint through the normal processes, you can submit an official complaint to the Principal Officer of the Society. The Principal Officer will assist you to resolve your complaint. Should you not be satisfied with the outcome you can request the constitution of a Complaints Committee as provided for in the rules. Should you still not be satisfied with the outcome you can refer your complaint to the Council for Medical Schemes who will adjudicate your complaint on your behalf.

GENERAL

When is the Annual General Meeting of the Society?

  • In accordance with the rules the AGM of the Society must be held on or before the 31st of July, member will be notified a minimum of 14 days in advance.

Can I request a copy of the rules of the Society?

  • Yes, all registered members of the Society have access to the rules as registered and approved by the Council for Medical Schemes. You can obtain a copy by contacting the Society on 086 000 2103 or logging on to the secure member portal.

How does the Society communicate with the members?

  • The Society do not distribute printed communication and will endeavour to contact all members via email and/or mobile options. It is therefore crucial that your contact details are always updated.

Does the Society adhere to the POPIA requirements?

  • Yes, the Society will only share health information of you and your dependants in line with the contracted agreements to ensure the provision of health services to you and your family. For example, the Society will share membership information with Netcare 911 who is the contracted emergency response service provider. Please note that the Society will share some information to ensure that you and your dependants can access medical services.