Hospital Plans vs Medical Aids

Often people who are looking for medical aids ask about a “comprehensive hospital plan” but really there is no such thing. A comprehensive medical aid is a plan that offers both day-to-day benefits and hospital cover. The day-to-day benefits include such things as doctors’ bills and medication. A hospital plan, on the other hand, is exactly what it says it is: cover for hospital expenses only. It does not cover day-to-day medical expenses.

So in summary a “comprehensive” medical scheme is any medical aid that offers cover for hospital expenses and out of hospital expenses too. Most of the large medical aids offer comprehensive cover and hospital plans depending on what you need. Get a quote now to see what is available and what you can afford. Simply complete the form and submit.

Comprehensive medical aid

Hospital Plans vs Medical AidsTypically belonging to a medical scheme is expensive. The great thing about it, though, is that you have total peace of mind knowing that you will never be faced with exorbitant medical bills, even if you are in hospital for a long time and need surgery and medication.

Hospital cover

These are entry level plans. At least you will be covered if you are hospitalised. However, there will be low allowances for day-to-day costs, if any. In this way a hospital plan is an extremely slimmed-down version of medical aid.

A negative point about a hospital plan is that the regulations can be quite restrictive. For instance, only certain kinds of major surgery might be covered, or you may have to stay overnight in hospital for the cover to kick in.

If you are young and fit then a hospital plan might be sufficient in terms of cost and your own medical cover requirements. When you get older it is wise to upgrade you medical aid to include better and more comprehensive benefits.

Most large medical aids have a large range of options so that your medical aid cover can be tuned exactly in accordance with your medical requirements and what you can afford. These are gap cover options that cover the payment gap between a hospital plan and full medical aids.

Unlimited Coverage Explained

 

Levels of medical cover

In many cases there is very little relationship between the levels of medical cover from comprehensive medical aid cover compared to a hospital plan.

While young adults might not have major medical expenses from day to day they may have to undergo emergency surgery should they be involved in an accident.

This is when the level of insurance of your health insurance cover becomes evident. For instance: a hospital plan might cover 150% of prescribed medical fees whereas a comprehensive medical aid plan might cover up to 300% of the standard tariff.

Specialists such as surgeons can charge as much as 300% of the medical tariff, so it is obvious that it makes sense to have a significantly higher level of medical cover.

What is involved in major medical coverage?

This type of coverage applies to major medical procedures like surgery or any medical event requiring anaesthetic for the purposes of medical investigation.

Most hospital plans only kick in with major medical coverage once you are hospitalised and most likely you will have to stay overnight in hospital. Unless you spend the night in hospital (such as when your wisdom teeth get removed) your hospital plan is unlikely to cover you.

What are the limits on hospital cover?

Every scheme has different levels of hospital plans and comprehensive medical cover. Examine each one carefully. Start by getting an online medical aid quote. It is best to do the footwork before you sign up because it is difficult to change medical aids at short notice.