CAMAF Member Option Guides & Info

2025 Essential Plus & Essential Network [Brochure]

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2025 MEMBER GUIDE - ESSENTIAL PLUS & ESSENTIAL NETWORK 5 Where a child or children are orphaned, the eldest child will be entitled to become the Principal member, at the contribution rate of a Principal member, with other child siblings as dependants. When any beneficiary dies, the date of termination will be the last day of the month and contributions would be payable for the full month. Does CAMAF have the right to cancel my membership? Yes - should you or your dependants: • join another scheme • provide false information or fail to disclose relevant information • commit fraud • fail to pay contributions • allow another person (other than a registered beneficiary) to access benefits using your card • neglect to inform CAMAF that goods or services paid for by the scheme were not received When am I entitled to claim from CAMAF? You can claim from the date you joined and paid contributions. What is a waiting period? In terms of the Medical Schemes Act, schemes may impose either a general waiting period, (while paying contributions) of 3 months (no claims paid unless Prescribed Minimum Benefits, where applicable) or a "conditionspecific" waiting period of 12 months where you have not been a member of a registered medical aid for a period of 90 days prior to joining or a period of less than 24 months. If CAMAF becomes aware of a pre-existing condition that you failed to declare on your application form, a 12 month exclusion will apply if your previous medical cover is less than 24 months. Pregnancy will also be underwritten and a waiting period will be applied where you have not been a member of a registered medical aid for a period of 90 days prior to joining or a period of 24 months. If you are joining via a member firm, you will have the first three (3) months free of underwriting provided you join CAMAF within the first three (3) months of your employment. If you join after the three (3) month period, you will be subject to underwriting. What is the inception date? This is the date on which your membership commenced and contributions become payable. It is always the 1st day of the month. Most medical schemes only resign members at the end of a calendar month. We therefore always register a new member from the first day of the month in which they applied for membership - even if your application is processed after this date. How are benefits pro-rated? If you or any of your dependants join the scheme during a calendar year (not on 1st January) all benefits that have an overall annual benefit limit will be pro-rated accordingly in terms of the number of months you or your dependant is an active member. Pro-rating does not apply retrospectively if you resign from the scheme prior to 31 st December. What conditions apply to resigning my membership? • If you are an employee of a company, where it is a condition of employment that you are a member of CAMAF, you may not resign, unless you are resigning from the employer group. • If you are eligible as a dependant to become a member of another scheme through your spouse, you may resign. • One calendar month's written notice should be given. • Any outstanding debt due to the scheme at the time of resignation must be repaid. • Back dated resignation is not permitted. What happens if I retire? If you retire from your employer on reaching the age of 60 or earlier as a result of ill health or disability you have the right to remain a member of the scheme. However, if the firm that you retired from leaves CAMAF, your membership will also be resigned. Why should I belong to a medical scheme? In many cases it is a requirement by your employer. Your employer needs to know that you will be fully covered in the event of an unforeseen medical event. Risks present themselves on the road, through criminal activity and lifestyle accidents, despite being young. Insurance cover on material goods (e.g., cars, property) is never questioned in terms of whether it will be used or not - how much more should accidental personal mishap be provided for. BACK TO CONTENTS PAGE

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