Medical Insurance for South Africans

Health and medical insurance cover is of the utmost importance – whether you require cover for chronic conditions or the peace of mind of cover in case of emergencies and illnesses requiring hospitalization.

Life insurance and medical insurance ensure that you and your family have cover when needed. Life insurance actually pays out a lump sum in the event of your death, making sure that your loved ones are provided for.


Medical insurance

So what is medical insurance? Medical insurance is generally paid out by medical schemes according to the National Health Recommended Price List – a nationally formulated price list for all in and out-of-hospital medical services.

Medical Insurance in South AfricaOnly a few schemes allow for pay outs based on the South African Medical Association – according to which most healthcare professionals charge.

Health medical insurance policies, on the other hand, pay out a set rate for every day a person spends in hospital. What a person uses the reimbursement for is up to them – be it for the cost of medical treatment or any day-to-day expenses that are not covered. A health insurance policy does not offer the same type of cover as medical insurance does.


Suiting peoples needs and finances

Medical aid schemes offer a variety of plans to suite people’s need and pockets. One of the most common and straightforward plans is a hospital plan, typically aimed at young, healthy individuals who do not require day-to-day or chronic medical care but wish to be insured in the instance of hospitalization and medical emergencies.

Hospital plans are usually the most affordable type of plan offered by schemes.

Many schemes offer the flexibility of medical savings accounts to their members. This means that members are covered for in-hospitalization but can manage their out-of-hospital expenses such as doctor’s visits, eye care and dental care.

Savings accounts are usually funded at the beginning of a year and should the funds deplete before the end of the year, members will be responsible for additional medical expenses incurred. Should there be remaining funds, those will be carried over to the next year.


Ideal for elderly people

Comprehensive medical insurance cover is ideal for elderly people and those who require chronic medical treatment and medication. Comprehensive types of plans will cover in-hospitalization expenses, as well as day-to-day expenses, chronic disease medication, Prescribed Minimum Benefits and various types of specialized treatment such as oncology and gynecology.

Preventative treatments will also be covered such as MRI scans, flu vaccinations, cholesterol tests and sometimes back treatment programs. Many plans will also cover maternity benefits.


Additional benefits

Numerous medical aid schemes will offer additional benefits for members such as points accumulation or premium discounts when joining a gym and attending regularly; quitting smoking; having regular preventative tests such as cholesterol tests and having regular health examinations.

Medical insurance in South Africa has become somewhat of a necessity for quality healthcare services and high-tech treatments.

Be sure to take your lifestyle, age and medical needs into consideration when choosing the right plan for your needs.