Understanding Hospital Plans and Medical Aids in South Africa - Medshield

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Understanding Hospital Plans and Medical Aids in South Africa

Posted in Articles   |   April 26th, 2021

Researching what kind of medical cover would work well for your lifestyle is one of the most important things you will do as an adult. Life is unpredictable, and the influx of road accidents, crime, and physical illness in our country requires every individual to take responsibility for their wellbeing. Although what happens to our health is not always within our control, ensuring that we are well covered should unforeseen medical expenses ever arise is a necessity.

One mistake many South Africans make is thinking that medical aid options and hospital plans are interchangeable, without really understanding the key differences between the two. Here at Medshield, we offer both, and endeavour to make information regarding these options easy to understand and widely accessible.

The Key Differences Between Hospital Plans and Medical Aid Cover

Medical aid options come in differently priced tiers, each one offering various value-added benefits depending on the option you select. Comprehensive medical aid cover might include everything from In-Hospital stays to those Day-to-Day medical expenses. Medical aid options come with perks, such as access to various wellness programmes, dental benefits, and better coverage of certain treatments and specialists. Hospital plans, however, are a type of risk-based insurance coverage, and monthly premiums ensure that in case of an emergency admission or the need for hospitalisation, you are covered.

While medical aids and insurance companies can both offer hospital plans, those offered by insurance companies are not regulated by the Medical Schemes Act and are considered financial products. Cash-back plans are another popular choice for South Africans and are heavily advertised in South Africa. These options pay out a lump sum to the member for each day spent in hospital, but by no means offer extensive enough cover for the cost of longer hospitalisations and procedures. Cash-back options should only be regarded as an add-on to your current plan.

What Suits You Best?

The more demanding your healthcare needs, the wiser it is to opt for comprehensive medical aid coverage. Large families with children benefit from wider coverage because of day-to-day expenses that arise out of visits to doctors, dentists, and specialists. Hospital plans only cover the medical costs of stays and treatments while a member is hospitalised. For patients who hardly ever fall ill or can manage the day-to-day expenses of doctors, dentists, and optometrists out of their own pocket, this is a more cost-friendly solution. Hospital plans are therefore better suited to:

  • Individuals without any health conditions or illnesses;
  • Young people who do not have many daily medical expenses that include visits to a doctor or requiring chronic medication;
  • Fit and healthy individuals with strong immune systems;
  • People with low-risk lifestyles.

Of course, extensive medical cover is always preferable, but for those who cannot afford a more premium option, hospital plans are a viable alternative that accommodates emergencies. At Medshield, our MediCore option offers unlimited in-hospital cover (along with full PMB cover). For more information on this plan or any of our other affordable and easy-to-understand options, view our benefit guides here or get in touch with us today.

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