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Choosing a Medical Aid in South Africa


 

  

  

Medical Insurance

 

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.

Medical InsuranceIt 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 hospitals.

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 insurance.

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 vehicles.

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 further: 

  • 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 holiday.
  • 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 insurance. 

Who should consider getting this type of insurance? 

  1. 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.
  2. 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