I am pregnant: why no cover after month’s interruption?

IN JULY this year, I cancelled my Government Employees Medical Scheme (Gems) membership, due to affordability. I reapplied (in August, a month later) and need to be registered on the maternity programme. My due date is December 29, 2017.

Instead, Gems has reinstated me for next year, with a new membership number, putting me on three-month waiting period to use the medical aid and 12 months to register me on the maternity programme. I feel disappointed and very depressed because I have no medical aid, no hospital booking, no doctor. How am I going to deliver to my baby? I have been with Gems for more than 10 years.

Gems must reconsider their cruel mistake, which they captured on my application, and recalculate correctly. I need to be put on the maternity programme immediately.

My baby’s life and mine are in danger due to this unfair decision. I am currently experiencing panic attacks. I am very depressed about this situation and I cannot sleep.

Georgie: Medical schemes assess the health risk profile of applicants and 12-month condition-specific waiting period for a pre-existing medical condition, such as pregnancy, is in line with the Medical Schemes Act. If you have not been a member of a medical aid for 90 days or longer, your cover is interrupted and you’re considered a new entrant to the scheme. A monthlong break in cover should not cause you to wait three months for cover, though, after long-term membership. I have taken this up with Gems.