Choosing a Medical Aid in South Africa




Hosmed Medical Aid Offers Salary Based Premiums

Hosmed medical aid offers hospital plan based medical aid plans that are different from most other medical aid schemes.

Hosmed medical aidThis is essentially one of a few network based medical aid schemes, where most of the services are provided by selected GP’s, pharmacies, dentists, optometrists and ambulance services. In the higher priced plans the choice of GP and specialists are however the sole decision of the member.

All of the premiums are based on your income, making this a very affordable medical aid. Another added benefit is that you only pay for the first 3 children.

The scheme pays 100% of their selected medical aid rates for claims and prescribed medication listed in the formulary.

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Listed below are the 3 available medical aid plans and the major components of their benefits.

Hosmed Step: This is a very basic medical aid option. The premiums are derived from the salary you earn and you only pay for the first 3 children. You need to nominate a GP for this plan.

Overall annual limit of R500 000 per family.

Hospital cover: Access to any private hospital in South Africa. The claims are paid at 100% scheme rates. Some listed conditions have unlimited cover.

Consultation cover: Unlimited GP visits at nominated GP covered at 100% of negotiated rates. 5 visits per annum for each member of the family, limited to 14 visits per family at non-nominated GP’s. 3 Specialists consultations per family per annum.

Limited Radiology, Pathology, Dentistry and Optometry benefits.

Hosmed Value: This is also an income based plan where you only pay for the first 3 children. In this plan you do not have a nominated GP, and can visit any GP or Specialist.

Overall annual limit of R1 million per family.

Hospital cover: Cover at any private hospital, paid at 100% of the scheme rates.

Consultation cover: 10 visits to any GP or specialist per family member, limited to 21 visits per family. Rates paid at 100% of the scheme rates.

Optometry and dentistry at preferred network service providers.

Limited Radiology and Pathology benefits.

Additional benefits: Physiotherapy, external prosthesis, mental health, nursing, ambulance services, alternative services, medical appliances, auxiliaries and HIV/Aids Program.

Hosmed Plus: As with the previous plans the premiums are salary based and you only pay for the first 3 children. The GP and specialist visits in this plan are not limited to nominated service providers.

No overall annual limits.

Hospital cover: 100% cover of medical schemes rate at any hospital.

Consultation cover: Cover at 100% of the schemes rates at any GP or specialist, limited to 16 visits per beneficiary and 26 per family. An additional 5 maternity visits are included.

Limited Radiology and Pathology benefits.

Dentistry and Optometry limited to selected service providers.

Additional benefits: Physiotherapy, mental health, ambulance services, external prosthesis, nursing services, HIV/AIDS program, auxiliary services, alternative services and medical appliances.

Hosmed medical aid truly assists members of the lower income groups with affordable premiums and acceptable benefits to ensure the health of your family.© Medical Aid Plan