While many need only an occasional painkiller or antacid, they worry about the high cost of a medical emergency. A hospital plan could relieve their concern. However, today, money is tight. World events like the COVID-19 pandemic and the prolonged hostilities between Russia and Ukraine have led to adverse knock-on effects on a global scale.
The pandemic taught us that even ordinarily healthy people can be vulnerable and that medical aid has become a necessity rather than merely a convenient option. However, the need is not just for financial assistance with medical bills but for cover that as many South Africans as possible can afford.
Since it was first introduced, the hospital plan has been the most cost-effective form of medical aid available. That said, more than 70 medical schemes currently operate in the country, and their offerings can differ considerably. Before committing to one, prospective members should examine the benefits of their chosen product in detail to ensure they receive value for money.
Possible confusion regarding a hospital plan
Although medical schemes now dominate this market, they were not the first to address the financial needs of hospitalised patients. The insurance industry first introduced this concept with a product they named a hospital cash plan. However, this option aimed not to cover the six-figure sums typical of surgery and a week or two in a clinic but to help patients cope with the more minor incidental costs associated with their stay, such as lost income, relative’s travelling expenses and similar contingencies. A payment is made each day the insured remains an inpatient, and its value is based solely on the monthly insurance premium.
By contrast, the focus of the medical scheme’s option is on assisting members with the actual cost of their investigation, treatment and accommodation, meeting most, if not all, of the related expenses. In the past, the two options had one feature in common. All their benefits ceased once the policyholder or member was discharged, and no day-to-day medical costs were covered.
However, the circumstances have since changed. Some schemes like KeyHealth Medical now offer their members a hospital plan with extended benefits, providing them with varying levels of day-to-day cover. Also, under the terms of the Medical Schemes Act 131 of 1998, all medical aid products must provide certain prescribed minimum benefits.
The challenge for the medical aid industry has been to comply with this legislation while attempting to keep their premium prices at a minimum. The market is a highly competitive one in which price continues to play a pivotal role.
Choosing the best hospital plan for your needs
You need a product you can comfortably afford but also want value for money. The easiest way for a medical scheme to keep prices down is to limit benefits, so be sure to check these carefully before signing on the dotted line. Here are some other features to check when evaluating a hospital plan.
- The portion of private healthcare expenses covered: While the Department of Health sets tariffs for all medicines and procedures, the private sector is not bound by these. KeyHealth counters this by using a network of designated service providers and supporting claims for up to 3 times the DOH tariffs, essentially eliminating co-payments.
- Extended benefits: Unless your general health is usually good, you might want to consider a plan that includes some out-of-hospital benefits. KeyHealth’s Origin option combines comprehensive inpatient coverage with specified day-to-day benefits.
- Free add-ons: Don’t confuse these with incentives like free movie tickets. Only additional core benefits will provide genuine value for money. Each KeyHealth product, from our entry-level hospital plan to our fully comprehensive Platinum product, includes three valuable added core benefits free of charge.
When you demand value, think KeyHealth
At KeyHealth our mission is to provide you with affordable medical aid and healthcare management services in an honest and transparent way. We can say with pride that we have a deep knowledge of and insight into the needs of our members that is based on real-time insights and health data.
If you need an affordable hospital plan, you will find no better value than a KeyHealth product. You can contact us to learn more about our popular product range and their free added core benefits.
