Hosmed Medical Aid Options Offer Value for Money

Hosmed medical aid options have been designed to offer value for money when it comes to both contributions and benefits. Hosmed also aims to provide “a sound healthcare solution” for its members.

The medical aid scheme offers a wide variety of competitive benefits and payment possibilities to make sure different medical and healthcare needs, and different affordability levels are catered for.

It is farily certain that every South African household that earns a fair income will be able to afford one or other Hosmed plan. There are, however, just four basic Hosmed Medical Scheme products:

 

  1. Plus
  2. Value
  3. Access
  4. Essential

All these Hosmed medical aid optionsare very similar, but they do vary considerably in terms of limits.

The Four Hosmed Medical Aid Options

Hosmed PeopleThe Hosmed Plus plan is the most expensive of the four Hosmed medical aid options, but it offers the most. For instance there are both in-hospital and out-of hospital benefits, and there is no overall annual limit. Benefits in state hospitals are unlimited, while 100 percent of the scheme tariff is paid for those choosing to be treated in private hospitals, including theatre fees, intensive care and medication.

100 percent of the scheme tariff also applies to in-hospital surgical procedures, including specialist and general practitioner consultations. A wide range of other costs are also covered at this rate, including diagnostic investigations, circumcision, oncology, blood transfusions, organ transplants, dental hospitalisation, renal dialysis, physiotherapy, and occupational therapy. Some treatments including psychiatry, drug and alcohol rehabilitation, surgical and prosthetic implants and sterilisation or vasectomy have limits.

Out-of-hospital cover is just as broad, making this one of the most attractive Hosmed medical aid options available.
Emergency cover is also available for members who travel outside of the country.

The Hosmed Value plan is another of the popular Hosmed medical aid options, and it also provides both in-hospital and out-of-hospital benefits.

Hosmed PeopleThe in-hospital benefits are similar to those in the Plus plan but with more limitations. The out-of-hospital benefits are comprehensive, including acute and chronic medicines, optometry, and dentistry. Alternative medicine is also covered, as are various remedial and other therapies, as well as psychiatry and psychology. Most of these have limits that are clearly specified in the medical scheme tariffs.

There is provision for air/road ambulance and emergency services.

The Value plan also has a wellness and lifestyle management programme that has been designed around risk appraisal and health screening. This includes a number of free annual tests (one each) for pap smears, mammograms, a test for prostrate cancer, a colon cancer blood test, cholesterol test, and a blood sugar test, as well as a flu vaccine. One free HIV test is also allowed for each beneficiary every year.

The Hosmed Access plan is currently limited to R1 million cover per family for a year. Cover is for both in the hospital and out, and comprehensive in nature. However, where there are limitations in terms of amounts, these limits are a lot lower than for the previous two plans.

One difference to the provisions of the two more expensive Hosmed medical aid options is that some procedures are subject only to the legally prescribed minimum benefits (PMBs). This includes physiotherapy and biokinetics, dieticians and occupation therapy, private nursing, and also medication for macular degeneration that is age related.

Like other Hosmed medical aid options, the Access plan does include emergency cover for members who need it while travelling outside of South Africa. It also has a wellness and lifestyle management programme that offers free tests, as well as consultations with dieticians and biokinetics specialists up to a certain limit.

The Hosmed Essential plan is the cheapest of the Hosmed medical aid options which are offered, but the overall annual limit is also the lowest of all four of the plans. At the same time, there is no annual limit on PMBs, and like the other Hosmed medical aid options,both in- and out-of-hospital benefits are included in the plan. There is a wellness and lifestyle management programme, and emergency cover is also provided for members travelling abroad.

It should be noted that for all Hosmed medical aid options, premium penalties apply if people join this medical aid scheme when they are older than 35 years.