SchemeBookUnderstand the system. Know what to ask.
by RiskAtlas
A window after joining where some or all benefits aren't payable yet.
Schemes may impose a general waiting period (up to 3 months) and/or a condition-specific waiting period (up to 12 months) when you join or upgrade, particularly if you weren't on another scheme immediately beforehand. PMB conditions cannot be excluded by a condition-specific waiting period, only delayed by the general one.
More jargon
Open scheme · Restricted scheme · PMB (Prescribed Minimum Benefits) · CDL (Chronic Disease List) · DTP (Diagnosis Treatment Pair) · Co-payment · Designated Service Provider (DSP) · Late-joiner penalty · Savings account / above-threshold benefit · Medical scheme · Medical aid · Medical insurance · Benefit option · Principal member · Dependant · Contribution · Underwriting · Condition-specific waiting period · Emergency medical condition · Medical savings account · Self-payment gap · Benefit limit · Scheme tariff or rate · Out-of-pocket payment · Provider network · Formulary · Generic medicine · Clinical protocol · Pre-authorisation · Managed care · Claim statement · Tariff shortfall · Claim rejection · Clinical motivation · Internal appeal · CMS complaint · Registered scheme rules