How to Join Hospital Plans
Sadly, millions of South Africans simply cannot
afford private medical care and the vast majority cannot even afford a medical aid plan. Many of these people
realize that calamity can strike at any time and that it is definitely preferable to be admitted to a private
hospital if such a drastic step becomes necessary. It is for people like these, and also for fit, young healthy
people, that hospital plans have been developed.
What are hospital plans?
The term “hospital plan” says it all. These plans are designed to cover the cost of
hospitalization. Some plans offer limited cover for out-of-hospital medical expenses but they are really not
designed to provide comprehensive medical cover.
Factors to consider when
evaluating hospital plans
- Some hospital plans also offer cover for
chronic conditions and even some other day-today medical expenses. For many people this may seem like an
unexpected bonus, but it is important to consider the cost implications. Nothing is for free and
out-of-hospital benefits will either increase the price of the cover or it will decrease the in-hospital
benefits and cover.
- Many people try to save money by opting for
hospital plans, citing cost as their reason for not choosing comprehensive cover. In many cases such decisions
are not based upon the reality. Too many people simply do not have their priorities straight. If you are able
to afford yearly holidays or a regular trade-in on your car, you should ask yourself if you are not falling for
false economy. Health is the most important asset any person can possible possess and it would be better to
sacrifice luxuries in order to obtain more comprehensive cover.
- Most hospital plans offers full cover for
in-hospital treatment. However, they do not always alert members to the fact that they will only pay according
to the approved medical aid rates. In some cases they are even willing to pay double the approved medical aid
rates. The reality can be harsh: most specialists and hospitals charge far above the approved medical aid rate.
In fact, four times this rate is normal practice. Members can therefore easily land up with the responsibility
to pay massive medical bills themselves.
- Some plans will not pay for the hospital
treatment of pre-existing conditions.
- Many plans will not pay for the treatment of
certain conditions within the first twelve months.
- Some plans include emergency medical
transport and others do not. This is an important point to keep in mind when selecting a specific
- Many plans will only pay the cost of
treatment if the member makes use of a pre-approved network of service providers. In such cases members have
little or no choice regarding the medical specialist or hospital he or she wants to
When comparing the benefits of various hospital plans it is extremely important to
study the terms and conditions carefully. If there are any doubts the scheme should be asked for clarification,
preferably in writing. It is generally thought to be best to choose a plan that allows the member to upgrade the
cover when circumstances change. © Medical Aid Plan