Medical Schemes, Cash and Affordable Hospital Plans in South Africa
The medical scheme industry is thriving but there is still a great need for affordable hospital plans in South Africa. The population is increasing and the latest medical legislation makes it compulsory for traditional schemes to fully cover and pay for certain prescribed minimum benefits, according to an official listing of conditions.
Despite extensive advertising in all forms of media, there still seems to be some confusion about what affordable hospital plans in South Africa really are. There are essentially three types of medical plans, the first of which is a medical fund which includes comprehensive cover for hospitalisation and procedure while there, doctor’s and allied visits and day-to-day medical expenses, including prescribed and over-the-counter drugs.
Medical aid hospital plans cost less than comprehensive options, have certain limitations on cover offered and still cover PMBs – prescribed minimum benefits which must be paid in full, as legislated by the regulator, the Medical Schemes Act. Members are covered for hospitalisation, in-hospital treatments, surgery, theatre and anaesthetics and procedures and materials used during their stay.
This is usually where the major expenses occur, expenses which can literally ruin a person or family financially forever, unless they have cover or millions sitting in the bank. Accidents happen in a flash; our road accident statistics and death toll are alarming in this country. Of course, accidents are not all traffic related.
Victims of crime, of whom there are sadly too many in South Africa, usually need some form of attention, even if they were fortunate and not exposed to physical harm. Trauma counselling helps them over the shock of being threatened or having their privacy invaded.
Disease can strike anyone at any time; related costs cannot be budgeted for and the disease may be debilitating or life threatening if left untreated. Support services, such as physiotherapy and occupational therapy may be essential to recovery. X-rays, MRIs, ECGs, CAT scans and sonar diagnostics could be employed initially.
All these procedures can be very costly, but if your or a loved one’s life or well-being is at stake, what choice do you have? An affordable hospital plan, in the true sense, will make a huge difference in these and other situations. If, like most plans, bar the executive type, top of the range
Our homes, possessions and vehicles are normally insured and those are things that money can buy – health is not, so why are some of us so resistant to take out some form of medical cover. “It won’t happen to me” loosely means that the likelihood of “it” doing so, is considerable.
Misunderstanding and confusion mainly occurs around the Cash-back hospital plans. A massive amount of money is spent advertising these, particularly on television, yet all too many folks are under the impression that this refers to an extremely affordable medical fund, which it is not at all.
These plans fall under the Short or Long Term Insurance Act and are not regulated by the Council for Medical Schemes – they are pure insurance products, which pay the beneficiary a fixed amount per day for the duration of his/her hospital stay. In most cases, cover only begins after two or three days, so the critical admission time has to be self-funded.
Private hospitals and clinics may well choose not to admit someone without what may turn out to be a large deposit, usually commensurate with the nature of the reason for admission. Cash-back options do not make provision for this at all.
Money paid out in terms of the plan can be used at the beneficiary’s discretion. This may be to fund hospital expenses, make up for a possible salary shortfall or go towards household expenses or anything else. None of this is very reassuring. Private hospital care is enormously expensive and it’s not becoming any cheaper.
Rather than have no meaningful cover at all, review your fixed monthly expenses, budget and decide what you can afford. Keep your age, general health, occupation and dependants in mind and review what type of plan best matches your needs.
This is the sensible way to start the process. Thereafter, review well known, reputable funds and their options.
We provide five very competitively-priced and affordable options, even including chronic cover on our most affordably priced plan, which a number of other funds have not covered in their least expensive options, in the past. See our website for details or contact us for assistance when shopping for affordable hospital plans in South Africa.