How To Choose Between a Medical Aid And Hospital Plan?

This year has already seen huge increases in medical aid fees, forcing many South Africans to ask themselves whether medical aid is a necessity. So how to choose between a medical aid and hospital plan? Here are some tips for you.

But, experts warned that the last thing that should be cancelled when feeling the financial pinch is health cover. It’s wise to consider other possibilities, such as switching to a cheaper option than the current scheme or moving to a hospital plan to ensure you have some cover in place.

So How to Choose Between a Medical Aid and Hospital Plan?

You could switch from a comprehensive plan to a cheaper option. Or even to a hospital plan if you and your family are rarely sick or don’t often need medical attention.

Before switching, it’s important to note the differences between medical aids and hospital plans.

Hospital plans cover accounts from service providers while you are in the hospital at a percentage that you choose (100%, 200% or 300%). The percentage is a base rate set by the Council for Medical Schemes. If you have cover at 200%, it means you are safe at the double the base rate. And if have cover at 300%, it means you are safe for three times the base rate amount.

You are also typically responsible for settling your own out-of-hospital and day-to-day expenses. And it’s cheaper than medical aid, but some hospital plan packages do include certain day-to-day benefits as well.

There are many hospital plans to choose from that do cover an array of expenses. They often also include the funeral cover, loss of limb or death cover too.

Medical aid covers a much larger amount of expenses (subject to the scheme’s rules). And includes benefits for in-hospital and day-to-day expenses (also subject to the scheme’s rules).

It’s also the option if you need regular medical treatment or suffers from a chronic condition (again, you will have cover depending on your scheme’s rules).

Medical aids also have limitations, exclusions and waiting periods, which the scheme determines. They do, however, have certain criteria to follow when declaring a limitation, exclusion or waiting period.

Medical aid schemes and hospital plans have to abide by the prescribed medical benefits list, which included 270 procedures, as outlined by the Council for Medical Schemes.

Final Choice – How to Choose between a Medical Aid and Hospital Plan

When choosing between a medical aid and hospital plan, identify your needs, work out your budget and explore your options. Often, using the services of an independent consultant is a huge help as they could help you choose the very specific cover for your personal needs without being biased.

All info was correct at time of publishing