It is often disappointing for South Africans, particularly women, to discover that hospital plans do not cover fertility treatments. This applies to both of the different types of hospital plans – a medical aid or cash back plan. The reasons may differ but the bottom line is that a hospital plan does not include cover for what is deemed non-essential, similar to cosmetic surgery. Many people wanting to conceive view fertility treatments as essential medical procedures but hospital plans are there to cover its members for medical costs accrued due to illness, especially since it can result in death in some instances. Seeking fertility treatments to fall pregnant is your right but in South Africa unfortunately, it is only an option those who can afford it and not for every medical aid member.
Hospital Plan Benefits
Waiting Period for Hospital Plans
There are different waiting periods for hospital plans and it is important to understand how this can affect your cover. In the ideal world, a person would sign up for a hospital plan, be it a medical aid or a hospital cash back plan, when they are young and healthy and do not need the cover. These financial products are a form of protection for when you need it in unforeseen circumstances, not for capitalising at the last minute when the situation is at hand. Waiting periods mean different things for different financial products but in terms of hospital plans with regards to medical and cash back cover, a waiting period means any span of time when you cannot claim but have to keep paying your premiums.
What is a hospital plan in South Africa?
A hospital plan can at times be a confusing financial product to South African consumers. All too often the term is used loosely by media agencies in the advertising of these products and consumers may sign up for these products without being sure of what they are buying. The South African financial services market is diverse, and there are products that often overlap. However, in most cases, a hospital plan in South Africa refers to one of two products – a medical aid hospital plan or a hospital cash back plan. Do not let the word ‘hospital’ detract from the fact that these are two totally different financial products.
Hospital Plans for Pensioners and Senior Citizens
Pensioners and senior citizens are just as much in need of a hospital plan, if not more so, than their younger counterparts. This refers to both medical aid hospital plans and a hospital cash back plan. However, there may be some issues relating to both these types of cover that seniors need to be aware of. First and foremost, medical aids cannot refuse membership based on age or health status but their may be implications in terms of cost and waiting periods. On the other hand, hospital cash back plans may refuse membership based on age – these are insurance policies and even if you are accepted as a senior, be prepared to pay a pretty penny for cover.
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.