How to Choose a Hospital Plan

Nobody will deny the fact that very few people have the cash reserves to pay for major medical procedures or the cost of emergencies. South Africans have free access to the public health system, but this system is overburdened and underfunded. That is why most people prefer to pay for private medical cover. However, not everybody can afford a medical plan that will make provision for all their medical treatment needs. The answer is often to opt for a hospital plan.

Why choose hospital plans?

The cost of comprehensive cover from a medical scheme is prohibitive and many people simply cannot afford it. However, in cases where major procedures or prolonged treatment in a hospital becomes necessary, the cost can be crippling. While many people can still afford to pay for visits to the doctor or for over-the-counter medicines, nobody can afford the cost of specialist treatment in a private hospital. That is why most medical aids provide the option of a hospital plan. Members enjoy no or very few out-of-hospital benefits but they are covered in cases of emergency. People that enjoy this type of medical aid are still covered in terms of the conditions on the Minimum Prescribed Benefit list as well. It is, therefore, an affordable alternative that will provide peace of mind that high-quality care will be available when calamity strikes.

Points to keep in mind when choosing a plan

• Some plans require members to make use of very specific hospitals and other service providers. Failure to do so may result in the member having to foot the bill personally. This may not be acceptable to some people. Schemes include this condition because they often negotiate better rates from certain service providers that agree to provide treatment and medication at specific rates. Such agreements often allow the schemes to offer their members cheaper cover.
• Many plans make provision only for the payment of hospital bills at approved medical aid rates. This is often even the case where members may choose the hospital of their choice. It is an unfortunate fact that many private hospitals and most medical specialists actually charge much more than this approved rate. In such cases, the scheme will hold the member responsible for paying the difference between the approved rate and the actual charges made by the hospital and the service providers. Members that are unaware of such conditions may be in for a very nasty surprise!
• Most schemes require their members to obtain authorization prior to hospitalization. In most cases, emergency situations are excluded from this condition.
• It may be wise to draw up a list of requirements and to request several quotations from different schemes before making a final decision. It may be better to choose a plan that can be upgraded if the situation changes.

Schemes such as Bonitas, Discovery Health, and Momentum pride themselves on the high quality of their customer care. It is always better to communicate with the scheme before undergoing any treatment or before admittance to a hospital. A hospital plan should be seen as insurance against major medical costs. Follow these steps on how to choose a hospital plan and you will not be disappointed. © Medical Aid Plan

NOTES:

Your medical aid quote will include options to suit your pocket. Please ensure that the cover you select is exactly what you need and that you understand exactly what insurance you are buying. Do not hesitate to ask questions about the medical aid or hospital cover you choose.