How You and Your Family Could Benefit From a Hospital Plan?

  • April 1st, 2024

How You and Your Family Could Benefit From a Hospital Plan

Due to the continuing global financial crisis, many South Africans cannot afford a comprehensive medical aid product. A hospital plan could be their best option. Healthcare costs are constantly increasing, but the trend has intensified during the last two years, in which first a pandemic and then the conflict in Ukraine have led to severe supply shortages and runaway inflation. Inevitably, the resulting price hikes have forced the nation’s medical schemes to increase their premium prices.

While these increases have, in most cases, been relatively modest, they have prompted some members to seek more affordable alternatives and even to consider purchasing a product from a competing service provider. Unfortunately, a large-scale migration could put a medical scheme and its members at risk, as these non-profit companies must maintain adequate premium income if they are to meet all their claims. To prevent such risks, retain existing members and attract new ones, most schemes have sought ways to encourage member loyalty. Some have chosen to offer incentives, while others have focused on upgrading the benefits of their products.

Don’t Confuse a Hospital Plan with a Hospital Cash Plan

You may have noticed an option offered by insurance companies that is significantly cheaper than anything you can purchase from a medical aid scheme. Beware! That extra four-letter word in the product description makes a world of difference. Firstly, insurers are answerable to a regulatory body which, unlike the Council for Medical Schemes (CMS), does not compel South Africa’s insurers to provide policyholders with the prescribed minimum benefits (PMBs). These include covering treatment costs for 26 chronic illnesses like diabetes, epilepsy, rheumatoid arthritis and multiple sclerosis.

Furthermore, these policies are not designed to cover all your expenses. Instead, they pay the policyholder a fixed sum for each day spent as an inpatient. In most cases, the total amount paid will fall far short of your hospitalisation and treatment costs. While a hospital cash plan might prove helpful to pay incidental expenses or to settle co-payments, only a genuine hospital plan from a registered medical scheme will provide the financial support you expect.

Medshield’s Extended Benefits on Hospital Plan Products

Initially, the medical aid plans were restricted to covering inpatient costs and best suited to young individuals with good general health. The inclusion of PMBs was a good start, but schemes have had to extend these basic benefits further to provide an affordable option that will meet a family’s needs. Medshield has developed several products to fill this role, including MediCore, MediValue and MediSwift. You can click here to review our 2023 product lineup in more detail.

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