Deciding on whether to opt for full (comprehensive) medical aid cover or a hospital plan only, depends largely on the individual and one’s budget. A hospital plan is more affordable and offers protection for the most expensive of services – hospital care. However, one’s medical needs may not require hospitalisation and can still be costly to the point that it can be unaffordable. In this respect, comprehensive cover or full medical aid cover offers the best of both worlds. Fortunately recent changes in private healthcare legislation has now offered the consumer, even those without full medical aid cover, the protection for certain life-threatening chronic ailments.
Being a member of a medical aid does not mean that you can access medical services from any provider without having to pay any cash fees. At times there is a misconception by medical aid members that a doctor or other medical service provider is forced to treat you and accept payment directly from the medical aid.
Any medical service provider in South Africa, whether a general practitioner, medical specialist, and auxilliary therapists like physiotherapists, psychologists, chiropractors and so on have the right to request cash payments for their services.
The termination of a pregnancy is the right of every expectant mother in South Africa. However, many women experience difficulty in getting the appropriate advice on the costs and facilities associated with an abortion. There are many private abortion clinics in South Africa and while government hospitals should also offer this service, the strained public health care system does not always give priority to abortions. Medical aids may cover the cost of an abortion, however, some medical aids limit the number of times the procedure may be conducted or may not cover the procedure at all.
Pregnancy is one of the times when a person reassesses their medical aid cover as the costs associated with childbirth can be expensive. Considering the high costs of private health care, it is only natural for mothers to be concerned about the extent of cover for their pregnancy and childbirth, as well as cover for any complications that may arise, especially those that can affect the baby. Proper cover is essential and ideally you should have comprehensive medical aid cover before you fall pregnant (refer to Medical Aid for Pregnant Women).
A hospital plan is medical aid cover that provides benefits for in-hospital (inpatient) visits and procedures. Most medical aid hospital plans also provide chronic medication cover. Private health care is expensive and hospital costs are staggering should you not have medical aid cover. A hospital plan is not a complete medical aid with day-to-day cover and out-of-hospital benefits but it is a cost-effective option for medical care should you require hospitalisation.
What is a Medical Aid Hospital Plan?
A hospital plan is a form of medical aid cover that provides benefits in the event that you are hospitalised. Medical aid hospital plans will pay for the doctor’s consultation fees, procedure costs, investigations and tests, medicines and your hospital stay.
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