Different Types of Health Cover in SA

When your options for health cover seem to be endless, it can be a rather tricky task to find the cover that best suits your needs. There are three main types of health cover in South Africa.

In this article, we take a look at the different types of health cover available to South Africans.

Three Types of Health Cover In South Africa

Medical aid

Medical schemes are non-profit organisations and must be registered with the Registrar of Medical Schemes.

Types of Health CoverMembers belonging to a scheme’s medical aid make contributions (monthly payments). And receive medical cover according to the rules of the scheme.

Each scheme has to provide a minimum set of benefits to its members, known as Prescribed Medical Benefits or PMBs. That includes a list of 270 procedures.

While any person can join an open scheme, closed schemes are for specific employer groups only.

Medical schemes can have many different medical aid packages, which cater to several members’ needs.

Hospital plans

If you’re new to getting health cover, a hospital plan is a good place to start, because it provides basic, yet important medical cover.

Most hospital plans cover all your required in-hospital procedures and check-ups and in most cases, you won’t have to pay any additional fees for procedures. Some plans also have day-to-day benefits, such as doctor’s visits, but this will depend on the method you choose.

Before signing up for any hospital plan. You should make sure you are familiar with the procedures that have the cover. As well as limits, exclusions and waiting periods.

A hospital plan is ideal if you are young and only require hospital cover for yourself. Or starting your career and looking for affordable medical cover. It’s also good insurance if you need to downscale on spending, but don’t want to cut yourself off of medical cover completely.

Hospital cash back plans

Hospital cash back plans pay out a cash lump sum to the policyholder if and when they are in the hospital.

The patient will be required to be hospitalised for a period of time before the payout is initiated. And in most cases, a predetermined amount of money is paid out over a predetermined amount of time. It’s agreed upon by the policyholder and the insurance provider.

The amount of cash paid out by these plans varies according to the chosen policy.