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.
Pensioner Medical Aid
If there is any time in life when you need medical aid the most, then the senior years are undoubtedly that time. As we get older, our body’s ability to overcome disease diminishes. Furthermore chronic diseases are more likely to develop as we get older and require lifelong treatment and management. Private healthcare in South Africa is expensive and the last thing any senior would want to contend with is the long queues waiting outside a government hospital for free medical services. For most South Africans, medical aid is the only option. Now that many doctors charge above NHRPL rates, you may also need to consider medical aid gap cover as well.
Costs and Benefits
Hospitalisation is also more likely in the senior years and even if you do not have out-of-hospital medical aid cover, a hospital plan at the very least is essential. Fortunately all plans now also offer chronic medicine cover as part of the hospital plan. Medical aids do not charge more or less based on your health status. But they do add a late joiner fee to the monthly premium if you sign up onto a medical aid after the age of 35 years. This late joiner fee is added to your policy for the life of your membership and does not fall away after a specific period of time.
It is therefore always advisable that younger adults retain their medical aid cover, even if they have to downgrade slightly. By starting up on medical aid later in life, you often have to pay for the age difference. With regards to pre-existing diseases, medical aids will not discriminate on this basis BUT you will have a waiting period of one year before you can start accessing these benefits. This simply means that for the first year of cover, you cannot claim for any expenses relating to pre-existing diseases. There is also a 3 month general waiting period where you are covered for any medical expense in the first three months of joining.
Pensioner Hospital Cash Plan
Although pensioners are not economically active, they are just as much in need of cash. Being hospitalised may bring about extra expenses in life. You may want the few extras with regards to hospital care. It may be a private ward or your doctor charges above medical aid rates and you are liable for the difference. In fact, most pensioners will require specialist care and this means having to pay for private rates out of your own pocket. Hospital cash back plans offer the financial protection you may need when in hospital by putting cash in your hand when you need it the most. Even the South African government may consider you to be a pensioner at age 60, there is a hitch once you pass the 65 year mark.
Options for over 65s
Most hospital cash back plans do not cover people over the age of 65 years. Unlike a medical aid that cannot discriminate against a person based on age, hospital cash back plans are insurance policies. If you have life insurance or dread disease cover then you will know the implication of passing the 65 year age mark. Insurance companies have to bear greater risk with this age group and will therefore not offer cover, or in the event that they do they premiums will be very expensive and often not feasible for the person, especially a senior on a pension.