As healthcare costs continue to escalate year on year, the pressure on state-funded medical facilities is increasing. Waiting lists are at an all-time high and show no signs of easing, forcing more South Africans to consider seeking attention from the private sector. While some wealthier citizens can meet private healthcare costs, others rely on medical aid funds and often choose a hospital plan as the most affordable option. While these products are certainly the most competitively priced, those who select them will need to be aware that they have pros and cons. However, before exploring these products in more detail, it is essential to differentiate them from similar options offered by insurance companies.
In practice, the nation’s long-term and short-term insurers were the first to respond to the public’s need for assistance with healthcare costs. However, their offering, which is still available today, differs markedly from the type of hospital plan devised by medical aid funds. The insurers offer their policyholders a cash sum based on their premium payments for each day spent as an in-patient. Those payments are only sufficient to help cover incidental costs, such as lost income, and amount to a mere fraction of the actual healthcare costs incurred. Consequently, the vast majority of those costs must be borne by the policyholders and their families.
By contrast, a hospital plan can offer members some significant benefits when obtained from a medical aid fund. Firstly, it will cover most, if not all, of the expenses arising whilst the member is hospitalised. Secondly, all medical aid products are required by law to include certain minimum benefits as directed by the Medical Schemes Act 131 of 1998. Those prescribed minimum benefits (PMB) include all costs relating to the diagnosis, treatment and care considered essential for 25 named chronic diseases and all medical emergencies. While such benefits may be invaluable pros, this type of limited cover may not suit everyone.
In practice, the hospital plan was a response by medical aids to the needs of younger people with good general health. The idea was to create a product that would shield them from the potentially crippling costs of treating the injuries arising from a road traffic accident or some other unexpected medical emergency. Given their usual healthy status, any expenses incurred as an outpatient, such as over-the-counter medication or GP visits, should present no hardship.
Unfortunately, a more fully comprehensive form of cover will generally be essential to meet the needs of an entire family. Should a family member be prone to ill health, a hospital plan could prove to be a false economy. Nevertheless, it is often the only option that many South Africans can now afford. It is, therefore, fortunate that much like George Orwell’s fictional farm animals, not all medical schemes and their products are equal.
Medshield is a fund with more experience than most, having been operating since February 1968. One of its most notable achievements has been to assemble a network of preferred service providers. The strategy has enabled us to maintain competitive premiums while offering some unique core benefits at no extra charge. Medshield provides a choice of benefit-rich hospital plans, including MediCore and MediSwift, which combines unlimited in-patient and full PMB cover.
Sources: URL https://www.medicalaid-quotes.co.za/medical-aids/medshield