What Young People Should Look for in Hospital Plan Insurance

  • March 18th, 2024

Under the current rules applied by schemes in South Africa, a young person can continue as a dependent on a parent’s medical aid until age 21. If, after that, they still rely on their parents for financial support, for example, while pursuing tertiary studies, most schemes will agree to extend the dependent’s cover until age 28. However, the time will inevitably come when they must seek their own protection, and hospital plan insurance is invariably the most affordable option. 

Affordable Access to Healthcare

In practice, medical aids developed this limited form of cover specifically with the financial limitations of young people in mind. Renting an apartment, buying a car and shopping for food can account for most of their income. That often leaves little to meet the higher monthly premiums of more comprehensive medical aid products. Instead, scheme managers postulated that most would enjoy good general health and only need help in case of an accident or medical emergency that might necessitate hospitalisation. Accordingly, the primary focus of a hospital plan is to provide the member with financial assistance whilst undergoing treatment as an in-patient. 

Hospital Plans Provide Prescribed Minimum Benefits

Not surprisingly, the specific benefits offered by this type of medical aid cover tend to vary between competing schemes. However, there is one feature that all are now bound to include. Following the founding of the Council for Medical Schemes (CMS) under Act 131 of 1998, all medical aid products must provide certain prescribed minimum benefits (PMB). These include the diagnosis, treatment and care for 26 chronic illnesses (including HIV/Aids). So, for example, an asthmatic or diabetic who opts for hospital plan insurance will still receive support with the treatment of these conditions, whether hospitalised or not. Everyone who selects this option will generally be responsible for any other outpatient expenses incurred during the membership year.

These include GP and dental appointments and visits to an ER. Anyone choosing this option should note that although many short-term insurers also offer a cheaper, similar-sounding product, it is actually a cash plan that pays policyholders a fixed sum for each day spent as an in-patient. The sums paid are only sufficient to cover incidental expenses such as lost earnings. By contrast, genuine hospital plan insurance offered by medical schemes should cover all or most of a member’s private healthcare costs while hospitalised. Furthermore, cash plans will not include year-round PMBs.

Following a sharp decline in the country’s economy, affordability and value for money have become high priorities for most South Africans today. With these issues in mind, Medshield strives to provide products that are accessible to most. For the young and generally healthy, we offer MediCore and MediSwift, exceptional hospital plan insurance products offering unlimited in-patient cover through our extensive network of healthcare providers. Click here to get in touch.

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