Hospital Plans, Medical Insurance and Comprehensive Medical Aid Plans

If you are a young, active and healthy individual or have just started a small family, you may benefit from choosing a hospital plan.

Selfmed’s MEDXXI plan offers a complete hospital plan. Get a quote now.


Nowadays, when choosing medical aid cover, people increasingly tend to opt for hospital plans or health insurance products instead of fully comprehensive medical aid plans. That is because hospital plans are more affordable than traditional medical aid plans, which in recent years have become a luxury for many families. People are also increasingly willing to manage their day-to-day primary healthcare expenses themselves by using facilities such as medical savings accounts (MSAs) or medical credit/debit cards.

Hospital plans do allow you more direct control over your medical spending and the management of your budget, but be aware that they differ significantly from medical insurance and comprehensive medical aid plans as regards the level of medical cover. Get a medical aid quote now for Selfmed's affordable hospital plan, MedXXI, or read on to learn more about hospital plans, medical insurance and comprehensive medical aid plans.

Comparing medical insurance, hospital plans and comprehensive medical aid plans

There are some key differences between these three types of product. Hospital plans occupy a middle ground of sorts between medical insurance and comprehensive medical aid plans, not as regards the level of cover they provide, but also as regards the cost. A hospital plan is the ideal option if you are looking for complete health cover for major medical expenses at a reasonable, fixed monthly cost. Review Selfmed’s hospital plan and its benefits to gain an idea of its features.

The difference between medical insurance and hospital plans offered by medical aid schemes

Medical insurance is a simple insurance policy that is offered by insurance companies, which covers you for a set amount per day for hospitalisation needs. Alternatively, such policies may pay out a set fee for specific procedures. Many insurance companies and even banks that have insurance companies who underwrite their policies offer medical insurance policies and called them 'hospital plans' or 'cash-back hospital plans'. Always read the small print and make sure that you understand all the exclusion and limitations.

So why not opt for a hospital plan offered by an insurance company?

Quite simply, hospital plans offered by a medical aid provide significantly higher levels of cover – and peace of mind – than the policies offered by insurance companies. A hospital plan, however, might cost slightly more than an insurance policy.

With most medical insurance cover plans, you can choose where you want an operation to be performed. What is more, any surplus amount – over and above the price you pay for the procedure – that the insurance pays out in a lump sum you may keep. Some insurance companies also offer you cash-back incentives and no-claims bonuses. This is very different from a true hospital plan offered by a medical aid scheme, which is a product that the scheme negotiates with hospital chains and which offers 100% cover of the agreed tariffs if a preferred provider is used.

Very often a good hospital plan offered by a medical aid scheme will cover unlimited in-hospital procedures, and it 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 R100 000 or more for a single person – much more for an entire family – especially if you need to stay in the emergency ward or intensive care unit of a private hospital.

If there are complications with an operation, costs can soar even higher. This is when a hospital plan is indispensable: It offers you the peace of mind of knowing that you are covered fully and won’t receive only a once-off payout on diagnosis of a condition or for a type of operation for which the benefits payable to you will be capped and limited.

Hospital plans from medical aid schemes are typically healthcare products whereby you manage day-to-day medical expenses yourself. This means that paying standard medical consultation bills and over-the-counter medicines remains your responsibility. Your medical aid scheme does actual payouts to the service provider, in this case the hospital, relieving you of all the hassles and paperwork associated with being hospitalised.

The difference between hospital plans and comprehensive plans

The key difference between hospital plans and more comprehensive options is that a comprehensive medical aid plan covers out-of-hospital expenditure such as regular doctor’s visits and medicines. Hospital plans usually do not cover these services; therefore, out-of-hospital expenses such as optometrists, dentists and alternative health services must be settled by the member.

Which plan should I choose – basic or comprehensive?

Speak to a consultant to help you determine your medical cover needs and discuss your medical aid options and benefits. Alternatively, get a medical aid quote now for Selfmed’s high-quality MEDXXI hospital plan, or compare medical aid plans online.

    More on choosing a hospital plan
    Paying for hospitalisation
    Hospital plans and emergency hospital admittance
    Pre-authorised admissions on hospital plans
    Overview of hospital plans

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