A hospital plan means different things to different people but these types of products do not end with a medical aid or cash back insurance. In fact there are so many related financial products in the South African market that it is confusing to consumers. Of course more people are aware of the common hospital plans – the medical aid for hospitalisation only or the insurance that pays you cash for each day in hospital. But there are also many add on products such as gap cover and premium waiver, both of which are only applicable to a medical aid, even if you only have hospital cover.
Plans for your hospitalisation costs
There is only one hospital plan that will pay for your stay and associated costs in hospital and that is a medical aid hospital plan. Remember that medical aids deal directly with the hospital to ensure that you are admitted and covered while you are being monitored or treated in hospital. Therefore private hospitals in South Africa accept these plans as a form of security. Doctors who are contracted into medical aid will also be covered directly by your medical aid. However, in the event that you doctor charges you private rates that are above what the medical aid will pay then you are responsible for the bill. This is simply what medical aid provides and more specifically the hospital portion of your medical aid.
Starting Price = approximately R500 to R700 but cheaper medical aid is available if you wish to opt for a plan that restricts you to just certain hospitals.
Plans for cash in your hand
A hospital cash back plan is a totally different financial product. Neither hospitals nor doctors will accept these insurance policies as a form of security for treating you. In fact hospital cash back plans do not pay or deal with the hospital or doctor directly. You as the beneficiary are paid for each day that you are in hospital for legitimate medical reasons. Whether you use this money to pay your hospital and doctor’s bills or whether you spend it on your personal expenses is entirely up to you. These hospital cash back plans are handy for supplementing your income but it is not a substitute for medical aid.
Starting Prices = about R25 per month but if you want better payouts per day then you should opt for plans that cost more than a R100 per month.
Top up hospital cover plans
The medical aid gap cover is simply a top up insurance policy to pay the difference between the medical aid rates and the private rates that your doctor may charge. Normally the patient is liable for the difference but with medical aid gap cover, you are protected from having to pay the top up difference from you own pocket. This type of cover is only relevant for your medical aid, whether it is a full medical aid or a hospital plan only. It will not top up on your hospital cash back plan. Furthermore, gap cover has a limit to just how much of the difference will be paid by the insurance company so you may still need to fork out some money from your own pocket at times.
Starting Price = R100 where the hospital plan may pay as much as 300% above what your medical aid pays out.
Plans for waiving your premiums
Medical aid premiums are costly but it has to be paid diligently every month if you want to keep your cover going. But what happens if you die or are disabled? Who will pay the premiums for you and your family? This is where the medical aid premium waiver comes in. It will cover you for up to 24 months or premiums should you die or be disabled. In this way, both you and your family are given a long reprieve to sort out the household finances to keep the cover active thereafter. The premium waiver policies are only for paying your medical aid premiums and does not cover your hospital cash back plan premiums.
Starting Price = about R100 per month which will pay up to R4,000 per month for your medical aid premiums.