Close this search box.

KeyHealth Member Information

Member Services

Electronic Communication

Debunking Myths About South African Hospital Plan Options


Many South Africans are confused about medical aid, per se, as well as the differences between hospital plans and hospital cashback plans. Some think that they’re all pretty similar, whilst others are under the impression that hospital plans that are offered by medical aid schemes and the cashback varieties are the same. Not at all, in fact, and the blame for these misconceptions cannot be laid entirely at the door of South Africans who either didn’t obtain all the required information about each, or who may not have understood why each option is different and separate from its counterparts.

Respective benefits or pay-outs are like chalk and cheese. It is essential to know the major distinctions between the three plan options in question – before you sign up for a plan. Failure to do so may end up being financially ruinous or even life-threatening, if or when something happens to you and you require hospitalisation, costly medical treatment, or expensive surgery, only to find that the cover or cash you were expecting does not exist under the terms of your plan and its benefits.

South African Medical Aid Options

Joining a medical aid scheme is similar to taking out a short-term insurance policy. For membership and cover, one pays a monthly premium. In the former instance, monthly payments are known as contributions. Each medical scheme offers a variety of plans. You have the option to choose between them, depending on what you need, and which option is affordable to you. Likewise, each option’s cover and benefits vary in accordance with your contribution. Legislation requires that every medical aid plan includes hospital, PMB, and chronic medication benefits.

Hospital Plans

Generally, medical schemes’ hospital plans are the most affordable options. While these so-called “hospital plans” include PMBs, chronic medications, and in-hospital costs cover, they may also offer several additional or free benefits, plus disaster or major medical expenses cover, as does KeyHealth’s.

Hospital Cashback Plans

Advertising campaigns, particularly those aired on TV, undoubtedly play a role in the public’s misconceptions about this type of product. Hospital cashback plan advertisements tell TV audiences that the patient receives a sizeable cash amount for each day spent in hospital, based on the monthly premium. The proceeds may be utilised to help pay for medical expenses while in hospital, or the recipient can use the money for anything else. Because the word “hospital” is attached to this option, some people equate hospital cashback plans with medical aid hospital plans, often to their detriment. The only link is that the benefit (cash), payment is dependent on the policy holder being hospitalised. Cash payments only commence after a few days following admission. Private medical institutions will still insist on upfront payment upon admission and for subsequent procedures and treatments. There is no actual medical cover.

Consider KeyHealth

KeyHealth’s most affordable medical aid plan, Essence, is somewhat similar to a hospital plan, because it provides cover for disaster and major medical expenses in hospital, but omits day-to-day, out-of-hospital medical cover. Certain terms and conditions apply, but in-hospital cover is unlimited, a most reassuring benefit that no pure South African hospital cashback option provides. Smartly and simply, KeyHealth is the way to go.