Sadly, the glory days of South Africa’s exemplary national healthcare service have long since become a distant memory. It was not a lack of skilled and dedicated doctors and nurses that led to its decline, but the escalating demand for treatment that eventually exceeded their capacity of an inadequately funded system to manage effectively. Long waiting lists soon triggered a move to the private healthcare sector for those who could afford the high fees or the premiums for comprehensive medical aid. For the less well-off, hospital plansoffer a more affordable means to obtain help in meeting some of the bigger private medical bills.
While there is no doubt that this type of private healthcare cover is a far more affordable option than any comprehensive medical aid product, it is vital to determine precisely what this cheaper option is offering. In practice, insurance companies were the first to provide financial assistance to South Africans whilst undergoing treatment as an in-patient. However, they were not offering the type of hospital plans available from medical aid funds today.
Then and now, the insurance company’s product was a hospital cash plan which pays the policyholder a cash sum, based solely on the premium price, for each day he or she is hospitalised. However, those cash payments cover only a tiny fraction of the medical costs. Consequently, most people who opt for this type of product do so to offset lost income, cover some incidental expenses or meet co-payments arising from their medical aid claims. By contrast, medical aid funds offer hospital plans that will cover most, if not all, of a member’s medical costs resulting from each instance of hospitalisation during a given membership year.
On the plus side, hospital plans, like all other medical aid products, are legally obliged to provide cover for the prescribed minimum benefits introduced under the Medical Schemes Act 131 of 1998. For example, if you are an asthmatic, have diabetes, are hypertensive or are affected by any of 26 other chronic illnesses, any expenses arising from these conditions will be covered both as an in-patient and an out-patient.
Now, more than ever before given the high unemployment levels, hospital plans offer a possible way to save on expenses. However, in tough times, good health and adequate healthcare are also more critical. So, though you may need to settle for cheaper medical aid, it is essential not to compromise on benefits.
Medshield acknowledges the need to maximise benefits and has responded by creating hospital plans that include many out-of-hospital benefits not generally covered by competitors. Furthermore, as an added bonus, all Medshield products also include some unique and valuable core benefits at no extra charge.