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Hospital Plan Insurance vs Comprehensive Medical Aid


Hospital Plan Insurance vs Comprehensive Medical Aid

Given the difficulties being experienced by the state-funded healthcare system and the steadily rising cost of obtaining private treatment, few South Africans can afford to be without some form of financial help to meet their medical expenses. With few, exceptions that help must come from one of the various products available from the nation’s medical aid schemes.

These can be broadly divided into two categories – limited and comprehensive. In practice, all products impose some degree of limitation, but none are quite as restricted as the hospital insurance plan. Literally, its benefits apply only to those days on which a member is receiving treatment as an in-patient. For the remainder of the year, all medical expenses are for the account of the member.

There is no doubt that being relieved of the expense of major surgery and all of the support it entails is a huge benefit. However, such cover is hardly suitable for someone with a chronic illness who may require year-round treatment and medication.

In practice, the biggest single benefit of a hospital insurance plan is that it its cheap. For this reason, it was designed to meet the need of young, single, and generally healthy individuals to ensure help with the potentially crippling cost of an accident or severe illness that might require hospitalisation. Typically, these young people are in their first job with a minimal income that is, however, sufficient to cover an occasional GP visit and any prescription charges.

By contrast, the cover provided by the more comprehensive medical aid products extends throughout the year. In addition, they provide cover for all the member’s healthcare expenses, including items such as dentistry, optometry, and audiology. In exchange, of course, the premiums are correspondingly higher and the maximum value of each benefit offered is determined by the amount of the premium paid.

Combining the options of both, KeyHealth offers an affordable entry-level product that extends the normally limited cover of the average hospital plan insurance product with a number of valuable year-round benefits.