Hosmed Medical Aid
South Africa is blessed to have many medical aid schemes offered to its citizens. It is therefore understandable if one gets mixed up and does not know which medical scheme would be best for their individual needs.
Medical cover as it is today is very costly and many people struggle to control their finances so as to get medical cover. After such effort, it is imperative that people get their money’s worth in terms of value from their monetary input.
Specific aspects of medical aids are important to consider e.g. cover for chronic conditions and details about hospitalization. Before making a decision on what medical scheme to go for, professional health advice coupled with some financial advice is important. Here we will take a look at one of the medical cover schemes. Hosmed Medical Aid.
Overview of Hosmed
Hosmed (Hosmedical) Medical Scheme was created in the year 1988 as a non-profit organisation. The scheme was registered under no. 313 by the registrar of Medical Schemes and governed by the rules and medical schemes of the same act. The scheme was started by local and provincial government employees who needed cover for their medical needs.
Today Hosmed Medical Aid is open and it covers medical needs for both the civil service people and people from the private sector. The membership currently totals more than 34,000 individuals with a trend showing more and more people coming on board from the private sector.
Hosmed Medical Aid has three basic products; the Hosmed Step option, the Hosmed Value option and the Hosmed Plus option.
Each option provides different extents in types of cover and different variety in cover. Each product will also attract different premium and initial costs.
Evaluating the different options:
Hosmed Step option
The Hosmed Step option is the most affordable and basic cover that is offered and it has the majority of members. The Hosmed step option is offered in all the major state hospitals and the state medical facilities.
For the step option privileges to be availed in any of these facilities, members have to produce a pre-authorisation slip that is usually given to all people who are covered. This cover includes the cover for chronic conditions including HIV and AIDS.
For cover in HIV and AIDS, members have to first enrol to the HIV management programme. Similarly, for air and road ambulance services, members have to first enrol with Netcare. This option does not cover over the counter medications, mental health, and remedial and other therapies.
Hosmed value option
The Hosmed value option offer covers for all that is covered in the step option plus the very important cover for over the counter medications though limited to R 530 per family per annum and R 127 per script.
Other added covers include; cover for sterilization, cover for mental health, cover for some alternative services, limited cover for a dental therapist, and limited cover for remedial and other therapies.
Hosmed plus option
The Hosmed plus option is the more comprehensive product available in Hosmed Medical Aid. This plan will have all the covers availed in the other products but will offer more in terms of the extent in cover. Despite the added allocations in cover, some benefits will still have limits.
Other medical aid schemes in South Africa that offer more or less the same health cover options for private and public sector workers include Gems Medical Aid and Bonitas Medical Aid.