How To Join Hospital Plans
December 27, 2012
Hospital plans have become affordable options for younger, healthier South Africans who do not need day-to-day medical care but do want some form of cover for cases of emergencies and dreaded illness. So how to join hospital plans is at the top of most South Africans’ minds.
Most medical aid schemes in the country offer medical hospital plans including Discovery medical aid. Have you looked at how to join hospital plans?
Consider your finances
Firstly, when looking at a hospital plan, consider if you could fund day-to-day out-of-hospital medical expenses yourself.
Hospital plans like those offered by Discovery Health do cover 26 chronic conditions, which is required by South African law and your scheme will insist that you acquire the medication from a designated provider. If you choose to get the medication from another provider you are liable for co-payments.
You will need to consider your medical needs when looking at how to join hospital plans. If you are older or have ongoing medical concerns then it’s better to choose a plan that covers out-of-hospital expenses.
Families medical history
Another thing to consider is your family’s medical history. Also, the onset of a sudden chronic condition can be bankrupting so joining a medical aid when you become ill, or later in life, can actually end up costing you more owing to your age and any pre-existing medical conditions.
By law, there could be exclusion for a period of up to 12 months from treatment for certain conditions. So it’s better to join a basic hospital plan when you’re young and upgrade as needed over time to avoid such restrictions.
Join hospital plans
When you’re ready to join a hospital plan, do careful research into what sort of cover you will be getting. There may not be complete cover for hospital expenses. Some schemes will pay up to 100% of the medical fund rate and others may even pay up to 200%.
Some plans and schemes have regulations regarding organ transplants, cancer treatments, emergency services, medical appliances, dental surgery, artificial limbs and HIV/Aids treatments. Check the regulations thoroughly. Find out what the overall limits are and what you have cover for.
Be sure to read the small print when choosing a plan. Find out if there is a designated service provider or network for the plan that you like.
Often utilizing the scheme’s network helps to reduce medical costs but it can also hinder your choice. For instance a designated service provider may be a state hospital. However, you may be unaware of that when signing up for the plan.
Hospital plans do have certain limits. Even when they claim to offer unlimited benefits this should be taken into consideration. If a scheme has low hospital limits that may mean insufficient cover if a member and a couple of dependents are involved in the same accident.
When looking into how to join hospital plans be sure to do your homework and decide which will work best for you and your family.
All info was correct at time of publishing