There is widespread misconceptions regarding different medical aid related financial products and hospital cash back plans. The confusion largely arises from the terms hospital plan and hospital cover which have become blanket terms to relate to any and every one of these products. Gap cover for medical aid is one of the newer products on the market. It is important for medical aid members to fully understand the benefits offered by gap cover and how it differs from a hospital cash back plan.
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Private Rates for Doctors and Specialists
It is sometimes confusing when comparing different types of hospital plans. Most seem the same and cost around the same price. However, when you are looking at a medical aid hospital plan it is important to take note of whether the plan covers private rates for doctors and specialists. Healthcare is confusing enough with all the medical jargon and then the talk of different rates for medical services often means that patients are lost and just go with what the doctor or medical aid says. However, the shock comes when you have to top up the doctor’s bill at the end of your hospital stay.
Maternity Benefits on Hospital Plans
The maternity benefits on a hospital plan is a consideration and concern for family members looking at having a child in the near future. But what hospital plan are you looking at? The term ‘hospital plan” in South Africa is vague. Are you talking about a medical aid hospital plan or a hospital cash back plan? Both are very different financial products and the nature of the maternity benefits on each type of hospital plan differs. It is imperative that you understand the differences in the maternity benefits as pregnancy and childbirth in a private hospital in South African can be very expensive.
Different Types of Hospital Plans
The range of different medical financial products can at times be confusing to the South African consumer. Medical aid. Hospital cash plan. Health insurance. The fact of the matter is that these are all different products with different benefits. There may be some overlap but each product caters for different eventualities. In order to compare hospital plans you have to realise that each product should be viewed separately. In other words, compare apples with apples.
Medical Aid Hospital Plans
A medical aid hospital plan is gradually becoming a popular choice among South Africans as it is significantly cheaper than comprehensive plans It is essentially still a medical aid but without the out-of-hospital cover that pays for day-to-day medical services. A medical aid hospital plan usually has a chronic medicine benefit included with the in-hospital cover. This means that a member on a hospital plan can rest assured of services when hospitalised in addition to medication for their chronic disease. A medical aid hospital plan should not be confused with a hospital cash back plan – the latter is not a medical aid.
National Health Insurance and Medical Aid Hospital Plans
South Africans eagerly await the final decision on the National Health Insurance system. Some are for it, while others against. It is the hope of many that they will get access to private facilities, and even medical aid members have hopes of reduced medical aid costs with the launch of the NHI. The fact of the matter is that all South African taxpayers, whether medical aid members or not, have to contribute towards the National Health Insurance scheme. This added expense may also be a glimmer of hope for medical aid members wanting to reduce their medical expenses.
Hospital Cash Back Per Day Cover
A hospital cash back plan pays you for every day that you are in hospital. It is not a medical aid and will not have the benefit of the in-hospital medical aid cover. In other words, hospital cash back plans will pay you cash but will not be accepted by any hospital or doctor as a means of reimbursement for medical services. This confusion abounds in the South African market where unknowing consumers sign up for hospital cash back plans with the misunderstanding that it is similar to a hospital plan medical aid. It is therefore important to understand the benefits and pros and cons of a hospital cash back plan with payment for each day of hospitalisation.
Hospital Plan Medical Aid for Pregnancy and Childbirth
There is no medical aid in South Africa, whether full comprehensive cover or just a hospital plan, that covers a women who is already pregnant for the upcoming pregnancy and childbirth costs. Right up until 2007 and 2008, a few restricted medical aids would consider waiving this policy in certain instances. Unfortunately this is no longer the case and unless there is mitigating circumstances, pregnant women have to pay cash for their pregnancy and childbirth bills. Hospital plans may be cheaper and offer lesser cover but this does not mean that standard medical aid policies will change for these plans.