What is a Hospital Plan?

  • March 25th, 2024

What is a Hospital Plan?

Medical aid schemes were introduced in South Africa during the ’60s. Their role was to assist their members in meeting the healthcare expenses incurred when undergoing treatment in the private sector. At the time, the monthly premiums were relatively modest. In exchange, the schemes offered reasonably comprehensive coverage for both in-patient and out-patient needs. However, much has changed since the ’60s. Healthcare costs in both public and private sectors have skyrocketed, leaving scheme managers to find ways to keep premiums affordable. The hospital plan has since proved a viable alternative to costlier comprehensive cover.

The Purpose of this Option

When first introduced, the plan’s purpose was to assist young single people with good general health to cope with the unexpected. A medical emergency, such as a ruptured appendix or a car accident, could leave them with a debt that might take years to pay off. Under the terms and conditions, private healthcare costs would only be covered during periods of hospitalisation and would cease on discharge. The correspondingly lower premiums were also helpful for those with limited income. Today, the hospital plan is in greater demand than ever from both individuals and families, but healthcare costs have continued to rise. Consequently, medical aid schemes have had to re-design their products to meet their members’ needs and budgets more completely.

Medshield’s Hospital Plan Options

Amendments to the Medical Schemes Act require all medical aid products to include full payment for the diagnosis, treatment and care of conditions defined as prescribed minimum benefits. These include 26 listed chronic illnesses. However, to avoid co-payments, members must use the scheme’s designated service providers. While this was a mandatory upgrade, medical aids have also extended hospital plan benefits in other ways. For example, Medshield’s MediSwift option offers unlimited in-hospital cover, physiotherapy and biokinetics benefits for amateur sportspeople.

Sometimes a main or dependent member’s general health might indicate the need for some support with day-to-day healthcare expenses. Medshield has a solution for this situation also. Our PremiumPlus option allocates a portion of the premium to a personal savings account. Members enjoy unlimited cover for in-patient needs while having funds available to pay for GP visits and prescription charges.

MediValue is our answer for those who want a hospital plan combined with the benefit of partial day-to-day cover. We offer a choice of a prime or compact membership with identical benefits. The latter provides lower premiums for members who agree to use the Medshield service provider network.

Be cautious – short-term insurers offer a cheaper product that pays a cash sum for each day spent as an in-patient, but it won’t come close to paying your bill. We invite you to learn more about Medshield’s value-for-money hospital plan options. 

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