How it works

How to change or cancel your medical aid without losing cover

By MedicalAidZA editorial team · 6 min read · Updated 29 September 2026

Safe gap between schemes: Under 90 days (and ideally none)
Same-scheme option change: No new waiting period (a running wait may continue)
Late joiner penalty: Can follow you to the new scheme
Notice to cancel: Commonly one calendar month, in writing (check your rules)
CMS Open Season 2026 advice: Finalise a switch by late November or early December

To change medical aid, you either move to another plan inside your current scheme, usually at the annual change window, or apply to a new scheme and then cancel the old one with written notice. Do it in that order and never let your cover lapse: a gap of 90 days or more lets the new scheme treat you like a first-time joiner.

The 90-day rule is often misreported. Switching inside 90 days does not remove waiting periods altogether. It limits the new scheme to one kind of wait, and to none if you moved because of a job change or an employer scheme change. Section 29A of the Medical Schemes Act sets this out, and the table below shows it.

This guide covers timing for 2027, the steps, what carries over, and what to do if it goes wrong.

Changing plans vs changing schemes

These are two different moves with different rules.

	Change plan within your scheme	Move to a new scheme
When	Usually at the annual change window	Any time
Waiting periods	None, unless one is still running on your current option	Depends on your cover history and gap (see below)
Your history	Stays with the scheme	Carries over only if you prove it
Paperwork	A plan change form	New application plus written cancellation of the old scheme

Section 29A(4) bars a new waiting period when you change from one benefit option to another in the same scheme, but any remaining wait on your current option may still be applied. Moving to a cheaper option is often the better answer when the cost of your plan is the problem. Our what if you cannot pay guide covers that.

When to switch: Open Season and the 2027 increases

Most schemes announce next year's contributions between October and November, and the plan change window normally follows. The CMS's Open Season 2026 guidance tells members to check what late joiner penalties or waiting periods may apply before joining a new scheme, and to finalise a switch by late November or early December.

For 2027, the CMS asked schemes in Circular 20 of 2026 to anchor increases at 3.8%. That is a benchmark, not a hard cap, and schemes that need more must justify it. By the end of September 2026 only Fedhealth and Medshield had published 2027 figures: Fedhealth reported an average weighted increase of 8.9% for 60% of its members, and Medshield a 7.9% weighted average. Discovery, Bonitas, GEMS and Momentum usually announce later. Compare final figures on our medical aid increases 2027 page before you decide.

The 90-day rule, stated correctly

What a new scheme may impose depends on how long you were covered before, and how long you were without cover:

Situation when you apply	What the new scheme may impose
Gap of 90 days or more, or never covered	General wait up to 3 months and condition-specific wait up to 12 months
Covered up to 24 months in a row, gap under 90 days	Only a condition-specific wait up to 12 months, not for PMB treatment, plus any unexpired wait
Covered more than 24 months in a row, gap under 90 days	Only a general wait up to 3 months, not for PMB treatment
Switching because of a job change, or your employer changed or ended its scheme, gap under 90 days	No waiting period

So the goal is a gap of zero, backed by proof of your earlier cover. Do not assume a certificate wipes out every wait. Ask the new scheme in writing which wait it will apply. The full explanation is in waiting periods and exclusions.

How to switch schemes step by step

Compare and choose the new plan. See how to compare medical aid plans.
Apply to the new scheme first, and get written acceptance, a start date and a statement of any waiting periods or penalty.
Ask your old scheme for a membership certificate showing your dates of membership, and give it to the new scheme.
Cancel the old scheme in writing once the new scheme has accepted you. Notice is commonly one calendar month, but check your scheme's rules and get the end date confirmed in writing. A ready-made medical aid cancellation letter and a switch medical aid transfer letter are available.
Line up the dates so the new cover starts the day after the old one ends.
Re-register chronic medicine, designated providers and any pre-authorisations on the new plan.

Never cancel first. If the new application is declined or delayed, you risk a gap.

What carries over and what does not

Carries over:

Your record of continuous membership, if you prove it with a certificate
A late joiner penalty, if you have one. Regulation 13(5) says penalties may continue when you transfer to another scheme. Check the new scheme's exact loading in the late joiner penalty bands.

Does not carry over:

Annual benefit limits, which start afresh on the new plan
Your medical savings balance, which is settled under the old scheme's rules and is not automatically credited to the new one. Ask both schemes how the balance is handled.
Chronic registrations, which must be redone with the new scheme's rules and formulary
Authorisations for treatment already planned

Time a mid-year switch so that a planned procedure is not caught between two schemes.

Cancelling without a new scheme

Cancelling and not replacing your cover is the costly move. After a gap of 90 days or more, a new scheme can treat you as a new joiner, with fresh waiting periods and, if you are 35 or older, a late joiner penalty. If you have been covered without a break of more than three consecutive months since before 1 April 2001, that history also protects you from being classed as a late joiner, so a long lapse can cost you that protection.

If the reason is money, downgrade first. A cheaper plan, a network plan or a hospital plan keeps your history intact. See hospital plans in South Africa and cheapest medical aid. Also check whether a restricted scheme, such as an employer scheme, would let you back in later before you leave it.

If something goes wrong

Ask your scheme to state any exit charge in writing, because a demand for one is worth questioning. If a scheme is slow to confirm your cancellation date, refuses a certificate, or applies a wait you think it should not, put your complaint to the scheme in writing. If it does not resolve it, you can complain to the Council for Medical Schemes at [email protected], after exhausting the scheme's internal process. Follow the steps in the CMS complaints guide.

Frequently asked questions

Can I change medical aid at any time?

You can apply to a new scheme at any time. Moving between plans inside the same scheme is usually limited to the annual change window. Confirm your scheme's rules.

How much notice must I give to cancel my medical aid?

Commonly one calendar month in writing, but check your scheme's rules. Ask for written confirmation of the exact end date, so you can start the new cover the day after.

Will I get new waiting periods if I switch schemes?

Possibly one. If your gap is under 90 days, the scheme may impose only a condition-specific wait of up to 12 months (up to 24 months earlier cover) or only a general wait of up to 3 months (more than 24 months earlier cover), and neither for PMB treatment. No wait is allowed if you switched because of a job change or your employer changed schemes.

Does the 90-day rule mean no waiting periods?

No. It means a gap under 90 days limits the new scheme to one kind of wait. A gap of 90 days or more allows both a general wait of up to 3 months and a condition-specific wait of up to 12 months.

What happens to my medical savings balance when I switch?

It is settled under the old scheme's rules, and is not automatically credited to the new scheme. Ask both schemes how the balance is handled before you cancel.