All medical aid schemes in South Africa offer hospital plans, which are affordable medical aid options designed to provide cover for all services rendered while you or your beneficiary is in hospital – accommodation, consultation fees, procedure costs & medication.
Most schemes negotiate a set tariff with a designated network of hospitals ensuring the cost of the hospital stay is paid in full.
Specialists and other health care providers, however, are permitted to charge private rates, which are often three to four times higher than the national guideline set out in theNational Health Reference Price List.
It is important to ascertain whether a particular hospital plan pays at 100% os scheme rate or private rates.
Benefits of Hospital Plans
- Hospital plans offer hospital cover at between 30% and 50% cheaper than comprehensive plans.
- Most hospital plans provide chronic medication cover for listed PMB conditions.
- Additional benefits, which vary from scheme to scheme, can include a take-home medicine benefit, limited emergency casualty benefits and limited benefits for terminal care, alcohol and drug rehabilitation, organ transplants, physiotherapy, oncology, renal dialysis and more.
Who Should Apply for Hospital Plans?
Hospital plans are popular and affordable medical aid alternatives for young, healthy individuals and families who do not have permanent or ongoing health problems.
They are the ideal option for individuals who are able to manage their day-to-day medical costs, such as over-the-counter medicines and consultations.