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.
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.
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.
COMPLETE THIS FORM TO GET YOUR MEDICAL AID
QUOTES!
 NOTES:
Your medical aid quote will include options to suit your pocket. Please ensure that the cover you
select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to
ask questions about the medical aid or hospital cover you choose.
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