So why not opt for a hospital plan offered by an insurance company?
Quite simply said, a medical aid offering you a hospital plan will offer you significantly higher levels of cover – and peace of mind - despite the fact that it might cost slightly more than the insurance policy.
With most medical insurance cover plans, you can also choose where you want the operation to take place. Additionally, any surplus that the insurance pays out in the lump – over and above the price you pay for the procedure – you even get to keep. Some of them also offer you cash-back incentives and no-claims bonuses. This is also very different to a true hospital plan offered by a medical aid, which is a product negotiated by the medical aid schemes with hospital chains, where 100% of the agreed tariffs are covered if a preferred provider is used.
Very often a good hospital plan will even allow for unlimited in-hospital procedures and usually pays standard medical aid tariffs or BHF rates. If you are involved in a serious vehicle accident, for example, your hospital bills could easily be upwards of R100 000 for a single person; and much more for an entire family to be hospitalised, especially if you need to be in the emergency ward or intensive care unit of a private hospital.
Also, if there are complications with an operation, costs can soar even higher. This is where a hospital plan is indispensable: It allows you to have the peace of mind that you are covered more fully, and won’t just receive a once-off payout on diagnosis of a condition, or for a type of operation where the benefits payable to you will be capped and limited.
Plans from medical schemes are typically healthcare products where you manage day-to-day medical expenses yourself, so paying standard medical consultation bills and over-the-counter medicines remains your responsibility. Actual payouts are done by your medical scheme to the service provider, in this case the hospital, so you are also not left with all the hassles and paperwork associated with being hospitalised.
Difference between hospital plans and comprehensive plans
The key difference between hospital plans and more comprehensive options is that a comprehensive medical aid plan will make provision for out-of-hospital expenditure such as regular doctor visits and medicines. Hospital plans usually do not cover these services, so out-of-hospital expenses such as optometrists, dentists and alternative health services will need to be settled by the member.
