All South Africans have access to the public
health system and, despite the many criticisms aimed at the system, it compares very well with many first world
public health systems such as that found in Britain and the United States.
It is an unfortunate truth, however, that the South African public health
system is seriously overburdened. More than eighty percent of the population depend upon this system and it
does not always cope well with the overwhelming demand.
The alternative is to pay for a medical aid plan
that will ensure treatment by private doctors and specialists and access to privately owned
Private health care is expensive and many people
simply cannot afford it. In addition, many people that are members of medical schemes find that their specific
plans do not cover all the cost of their treatment and that they are liable to pay large sums of money despite the
fact that they are covered by a medical aid. It is these people that can truly benefit from medical
What exactly is health insurance?
Medical insurance plans are not the same thing as
medical scheme plans. Many insurance companies offer this type of insurance without being registered as a medical
scheme. It could be seen as similar to the policies that people buy to cover their house content or their
The insurance pays out a certain amount when
certain criteria are met. In this case, the insurance will pay a specific sum for each day that policy holders
spend in hospital. The amount varies according to the policy chosen but it typically varies between three thousand
and five thousand rand per day. The following factors may clarify matters
- The insurance company pays the cash to the
policy holder and not to the medical service provider. The policy holder is under no obligation to use the cash
for medical expenses. In fact, he can do anything he wants with the money; even go on
- Most insurance companies only pay from the
third or fourth day spent in hospital. In other words, if a policy holder spends two days in hospital there
will be no payment made.
By law, no South African citizen may be member of more than one medical
scheme. However, nothing stops somebody from joining a medical scheme and take out
Who should consider getting
this type of insurance?
- People that simply cannot afford a medical
aid plan should seriously consider insurance. Treatment at a private hospital can be extremely expensive and
with insurance at least part of the cost is covered. Many people receive no income if they are hospitalized and
the payments may help to keep the family afloat.
- Many medical aid plans require members to
take responsibility for part of the cost of hospital treatment. Some schemes pay only approved medical aid
rates while the actual charges can be as high as four times that amount. Insurance can help them to make
provision for the shortfall.
There can be little doubt that medical insurance can help to limit the cost of
treatment in hospitals. Hospitalization alone is already traumatic for most people but the cost of such treatment
can certainly multiply the stress. © Medical Aid Plan