Medical Aids/Hospital Plans

Medical Aids and Hospital Plans

healthcareMedical aid is a product where a member buys “benefits” from a specific medical scheme. The medical aid then pays for medical costs of the member, but coverage and payment will be as stated by the specific medical scheme.

Different medical aid cover options are available

There are various medical aid plans available to members. They can choose between:

  •     Hospital plans
  •     Hospital plans with a savings component (New Generation Options)
  •     Traditional plans
  •     Comprehensive plans and
  •     Network plans
  •     Gap cover

These, of course, range in price.

If you want the most affordable medical aid for you – understand what the product offers you, before you make an informed decision.

Basic hospital plans are recommended for an active and healthy family. If you take responsibility for your own health and know that prevention is better than cure, it will work for you. However, the disadvantages include co-payments on certain procedures such as gastroscopy, colonoscopy, laparoscopy, extraction of wisdom teeth, cataract removal, etc.  Some procedures might also not be covered at all.

Hospital plans with savings cover accounts (New Generation Options) are submitted by service providers – only for in-hospital expenses. You are responsible for your own day-to-day medical expenses. These plans cost less than comprehensive medical aid plans. Such plans are recommended for individuals and families who require comprehensive cover if they need to go to hospital in case of an emergency or for a planned procedure. It is also recommended should you want to enjoy the flexibility of a savings account for day-to-day expenses.

Comprehensive plans have a savings component and cover almost all medical expenses and include benefits for in-hospital, day-to-day expenses and chronic medication.
These are subject to the rules of the scheme and are recommended for individuals or a family who want comprehensive cover for emergencies, hospitalisation, day-to-day expenses and who makes use of quite a lot of chronic medication.

Traditional plans cover almost all medical expenses and include benefits for in-hospital, day-to-day expenses and chronic medication, subject to the rules of the scheme. These plans are recommended for individuals or a family who want comprehensive cover, but do not want a savings benefit on their option. These options still cover emergencies, hospitalisation, day-to-day expenses and chronic medication.

This can become a bit of a mine-field if you are looking for a plan –

give us a call and an accredited healthcare advisor will guide you through the selection process and recommend a plan that best suits your needs.