What Does a Hospital Plan Cover in South Africa?
Given the ongoing trend of rising private healthcare costs as new medications become more expensive and medical equipment becomes more complex, it is hardly surprising that medical aid tariffs tend to follow suit. It is for such reasons that many people are now asking: “What does a hospital plan cover in South Africa“?
The latter option is markedly less costly than a comprehensive medical aid plan and can be sufficient to meet the needs of those whose overall health is generally good, such as young, single adults and new professionals.
That said, before making a commitment, one should have a clear understanding of what is covered by a hospital plan and what is not. So, it can be particularly important to note hospital plan benefits in South Africa and to be aware of any hospital plan exclusions.
Typical Hospital Plan Benefits: What Does a Hospital Plan Cover in South Africa?
When asking, “What does a hospital plan cover in South Africa?”, the answer will depend on the chosen scheme. In most cases, the answer is “the bare minimum”, but KeyHealth is a notable exception, with the Essence hospital plan cover list including limited day-to-day benefits and add-ons at no extra cost.
In practice, when it comes down to what does a hospital plan cover in South Africa, we have raised the bar with our entry-level Essence plan. In most cases, people wondering what a hospital plan covers in South Africa would not expect to enjoy benefits such as the Easy-ER option available with Essence. This includes a card for children that allows them to be taken to any ER and receive immediate treatment, should the need arise.
A Quick Look at Our Hospital Plan Day-to-Day Cover
Whereas in most cases, hospital plan benefits in South Africa do not provide routine day-to-day cover for most members, every medical aid product, including hospital plans, has a legal obligation to cover the diagnosis, treatment, and care of the chronic conditions on the Chronic Disease List, along with defined emergency care, under prescribed minimum benefits set out by the Council for Medical Schemes.
Essence: Some Highlights of the Hospital Plan Cover List
Essence covers a wide range of procedures and events, covering both routine hospital admissions and major medical episodes, as set out below.
During private and state hospitalisation, cover includes:
- Varicose vein surgery
- Joint replacement
- Prosthetics
- Specialist and anaesthetic services
- Supply of medication on discharge
For major medical events, cover extends to:
- Transplants
- Dialysis
- Oncology
- Radiology
- Pathology
- Blood transfusion
- Endoscopic procedures
The hospital plan provides an affordable way to offset some of your medical expenses, but it’s crucial to recognise its limitations. So if you are still wondering, “What does a hospital plan cover in South Africa?”, it’s time to seek some professional advice.
Don’t delay, see exactly what KeyHealth hospital plans cover, and get a quote suited to your needs today.