Difference between Medical Aids and Hospital Plans
People in South Africa often confuse hospital plans with medical aids. Although both provide payment for in-hospital treatments and medication, hospital plans don’t cover out-of-hospital expenses.
Most of the hospital cash plans in South Africa work on cash payouts, which can be used by the patient to pay for medical costs or any other costs associated with not being able to work during the period. The money is paid directly into the patient’s account and is limited to a set amount daily. Hospital plans also exist where payment is only made from a specific day in hospital, for example, they will only pay the member after three days in hospital.
With more comprehensive medical aids, such as KeyHealth, you normally have comprehensive hospital plans to cover the in-hospital treatments and medicine, while the member also has a day-to-day cover for out-of-hospital medical expenses, including dentist, doctor visits, tests, glasses and more.
Understandably, people often only opt for hospital plans because they want to be sure that they will be able to afford a private medical facility should they need to undergo surgery or are seriously injured in a motor accident. However, having a full medical aid that includes hospital coverage can be affordable enough to ensure the above and to make provision for out-of-hospital treatments, such as removal of wisdom teeth or general doctor visits.
With the day-to-day savings account system a portion of the member’s monthly contributions is paid towards the savings account. The money from the savings account is specifically allocated for day-to-day out of hospital medical expenses. At the same time, the member still has comprehensive in-hospital benefits, but because of the system, they now pay less for medical aid.
KeyHealth offers several benefit options, which include hospital plans. The benefit packages differ in terms of monthly contribution amounts and the limits of the coverage in hospital. We have an extensive network of designated service providers throughout the country and offer our members extra free services, which help to make the medical aid even more affordable.
Such services include the Health Booster Plan, which is linked to the member’s benefit package and includes to the limit of the benefits package a range of preventative healthcare services, such as annual screenings for diseases such as diabetes, prostate cancer and more. In addition, the members have access to free vaccinations and immunisations according to the stipulations in the Health Booster Plan, as well as the weight loss management programme.
We furthermore offer the pregnancy support programme for registered pregnant members from their 12th week of pregnancy in which they receive discount vouchers, hampers for mother & child, online information, consultancy follow-up on the progress of the pregnancy, and newsletters related to the specific period of pregnancy among other benefits.
Our Easy-ER is available to the registered child dependants of members and make it possible for the children to have access to the ER for conditions as stipulated on the Triad system. We pay the full bill (according to terms and conditions) and the member doesn’t have to make any upfront payments. This service is available even if the member doesn’t have any benefits left.
If you thus have to choose between hospital plans and medical aids, consider the benefits of having a comprehensive medical aid that’s affordable and helps you to save on day-to-day medical costs. Contact us for more information about our various benefits packages today.
