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.
medical aid
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.
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 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.