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Choosing a Medical Aid in South Africa


 

  

  

How to Choose Hospital Plans


A look at why we need medical insurance and how to choose hospital plans.


What is a hospital plan?

A hospital plan is a form of medical aid plan provided by a medical aid scheme to help the member pay for in-hospital costs and treatments. The hospital plan usually do not provide any day to medical cover, but there are certain medical aid schemes in South Africa that has hospital plans that either include limited day to day benefits or a small medical savings accounts.

How to Choose Hospital Plans

Hospital plans are a more affordable medical aid option because it only supplies cover for treatment in hospital. All forms of medical insurance is based on risk, the risk of ending up in hospital is much smaller than the risk of getting a sickness that can be treated by GP visit only, this is also a factor that reduces the costs of hospital cover.

Hospital plans from medical aids v plans from insurance companies

If you don't learn anything else from this article, please remember that a hospital plan from a medical aid scheme such as Discovery, Momentum, Fedhealth, Selfmed, Sizwe, Bestmed, etc. is in general preferable to a hospital plan from an insurance company. This because medical schemes are obliged by law to cover a wide variety of chronic and other health conditions in their products, while insurance companies are not.

Hospital plans take mainly 3 forms:

• Network hospital plans that require you to use a network hospital.

• A general hospital where you are allowed to use any private hospital.

• A hospital or cash back option provided by an insurance company, these plans have extremely limited benefits.

Why do we need them?

We need hospitals mainly because of the high costs of the medical care provided in private hospitals. The hospital plans also provide you with the peace of mind that your hospitalization cost will at least partly be covered while you are in hospital.

How to choose hospital plans

It is a difficult decision whenever you choose to commit to any long term financial costs; these are factors that you should consider when you choose a hospital plan that will help you get the most from your plan.

Choose plans that:

• are provided by medical schemes registered with the Council of Medical Schemes. The council regulates and monitor all schemes to comply with the medical schemes act and provide you with benefits that suit the premiums. This will also means that you at least covered for the 270 conditions listed in the prescribed minimum benefits list.

• provide you with the best benefits. Most schemes now provide additional benefits that will assist in prevention and screening for certain diseases. Other additional benefits may also include; a limited day to day or savings account benefit.

•you can afford. Medical cover are expensive, choose something that provide adequate benefits for the premiums you pay.

• provide you with unlimited annual limits. This is crucial in the event of an accident or extensive treatment because of the high costs of the hospitals especially during extended or long hospital stays.

If you take all these factors into consideration you will know how to choose hospital plans that will provide you with the best cover possible.