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What Does A Hospital Plan Cover? Should You Get One?


Every medical scheme has its own packages, and hospital plans may vary from scheme to scheme. However, some typical points distinguish hospital plans from medical aid. One obvious aspect is that a hospital plan only covers procedures and treatments done in hospital. That’s the main fact to consider when choosing between packages. If you want a safety net to cover for those unexpected accidents or large bills that come with being admitted, then this option could work for you.

Pros and cons of a hospital plan

If you’re seeking full cover for day-to-day benefits, specialist appointments and regular trips to your general practitioner, a hospital plan isn’t the best option for you. Less expensive hospital cover can, however, be better in certain cases.

The pros of hospital plans include:

  • Cheaper premiums than full cover options
  • If you use a Designated Service Provider (DSP), there are very few restrictions on care and often limited to no co-payments
  • It’s available when you need it most, like when a dependant is hospitalised suddenly
  • It has to include benefits for a set list of chronic conditions

The cons of hospital plans include:

  • No cover for simple medical services out of hospital
  • Fixed limits for days admitted
  • Prescribed Minimum Benefits (PMBs) are not included in all plans

Who should get a hospital plan?

If you don’t have health issues, rarely need to go to a doctor, and don’t use medicine regularly, you can consider a hospital plan package. Another factor that might make a hospital plan the safer option is your budget. It doesn’t matter if you have the best medical aid, but you keep missing payments because you can’t afford it.

If you aren’t spending a big part of your salary on medical expenses each month, you could benefit from a cheaper option. This way, you’re assured that you’re covered in case of emergency, and you can still visit a doctor if you’re feeling ill.

For the abovementioned reasons, hospital plans are popular among younger folks.

What does a KeyHealth hospital plan cover?

KeyHealth’s most budget-conscious package is our Essence option, which includes an unlimited hospital plan and PMBs with an unlimited value. It also features unlimited cover for medication related to conditions on the Chronic Disease List (CDL). And, as with all our options, you receive free additional benefits:

Essence offers benefits with unlimited value that include cover for emergency ambulance travel, scopes, hospital bills, injuries due to accidents, and in-hospital specialist fees.*

*Subject to Scheme rules, clinical protocols per option and the use of DSPs.

Lastly, members also receive set cover for MRI and CT scans, oncology and medical appliances. You can find more detail on this option here.

Do you save money with a hospital plan in the long run?

The answer to this question depends on your lifestyle. If, for example, you have a family of four – two kids and a spouse – for which you provide, a more inclusive package may be advantageous. Even if you’re all fairly healthy, there is a higher likelihood that someone in your family will get sick. This means that you will more regularly have to visit a health practitioner or purchase medication.

If you and your loved ones don’t require healthcare services more than once or twice a year, you can save by not paying a high monthly premium for medical aid and opting for an emergency option such as a hospital plan.

A simple plan is better than not having any cover and can save you from financial disaster should any beneficiary of the plan be hospitalised. And, with accidents and critical conditions usually being unexpected, it is safer to have this type of insurance in the long run.

Be safe – Take out health cover

Don’t wait until it’s the last minute and you’re in an unmanageable situation. Sign up for medical aid; whether it’s a simple plan or complete package. Avoid the risk of overwhelming financial loss due to healthcare costs by making sure that you and your loved ones are covered.

Get a quote from us online and sleep easy knowing that you and your family are taken care of.