Medical Scheme Clause Samples
A Medical Scheme clause defines the terms under which medical expenses or health insurance coverage is provided to individuals, typically employees, under a contract or policy. This clause outlines eligibility criteria, the scope of covered medical services, and the process for claiming benefits, such as whether dependents are included or if pre-existing conditions are covered. Its core practical function is to ensure that parties understand their entitlements and obligations regarding healthcare benefits, thereby reducing disputes and providing financial protection against medical costs.
POPULAR SAMPLE Copied 1 times
Medical Scheme. You and your immediate family shall be entitled to participate in the medical insurance scheme maintained from time to time by the Company for the benefit of employees.
Medical Scheme. 5.7.1 The rules of the Company’s medical scheme may make membership compulsory for the Employee.
5.7.2 The Employee will be liable for the full cost of the medical scheme and such costs will be deducted from the Employee’s Cost to Company Package.
5.7.3 The Employee undertakes to become acquainted with the rules of the applicable scheme.
5.7.4 Any schemes available may reserve the right to determine eligibility to the scheme. Therefore the Employer cannot guarantee that membership of any scheme will be permitted, with or without special conditions being applied to individual members. The final decision to admit any member rests with the scheme.
5.7.5 If the Employee retires from the Company and the Employee continues membership of the medical scheme. The Company does not subsidise pensioner medical costs and all contributions payable will be for the account of the Employee pensioner.
Medical Scheme