Hospital Insurance in South African Explained
Hospital insurance is completely different from medical aid. But it is just as important.
People often become confused when they read about hospital insurance, hospital plans, medical aid and health care plans. They do not know what the difference is between the various terms are. In essence, there are two types of medical cover:
- Comprehensive medical aid plans offer their members a full range of medical expense options. These plans normally include day-to-day medical expenses, including services from general practitioners, dentists and optometrists. Members also have cover for the cost of chronic medicines and in-hospital procedures. It also covers many other benefits that relate to their general health and well-being. Medical schemes offer many medical plans. Their terms and conditions differ widely and these plans are normally rather expensive.
- A hospital plan and hospital insurance is basically the same thing. These plans offer insurance against hospitalization. They do not cover day-to-day medical expenses. The various plans on offer by the schemes all offer in-hospital care and cover for the cost of many procedures whilst in hospital They do not cover emergency treatment costs and they do not cover the cost of medication after discharge from hospital.
Who should consider hospital cover?
- Young, healthy people hardly ever consider the consequences of a medical calamity. Nobody can possibly live in the hope that an emergency will not occur. Accidents happen; people become incapacitated in the prime of their life, appendixes burst and cancer strikes indiscriminately. These are the facts. It is vital to be realistic and to accept the fact that when such catastrophes befall somebody that the medical cost is going to be astronomical. These plans are ideal for people that are young, fit and healthy.
- People that are not able to afford full cover should seriously consider this type of plan. It will not pay for dentists, psychologists or general practitioners but it will ensure cover for all the costs of hospitalization. Hospitalization and surgical procedures can be horrifically expensive and very few people can afford it. This type of plan is vital because it is impossible to predict the future; an accident can happen at any time and everybody wants to be sure that they will be able to get the very best treatment in such cases.
How to choose a hospital insurance plan
All the health care service providers offer hospital plans and consumers can become bewildered when faced with such a wide variety. The following pointers should be kept in mind when evaluating the various plans:
- Consider only plans that are offered by reputable health care service providers.
- Read the terms and conditions very carefully and ask for clarification when there are questions.
- Assess the health and medical needs of all members of the family and look for a plan that will address those needs.
- Experts recommend a plan that allows the member to upgrade to a more comprehensive plan when circumstances change or when the medical needs of the family change.
- Some plans offer additional benefits such as emergency treatment, trauma counselling and take-home medication after hospitalization.
It is vital to make provision for medical expenses. Ideally, full cover is the best but if this is not possible, hospital plans can at least ensure that all the members of the family are covered for hospitalization. The public health service is overloaded and underfunded and it is unfortunately not always able to provide the very best care speedily.