Private Hospitals for Non-Medical Aid Patients, Costs and Care

Private Hospitals Accept Patients Without Medical Aid

There is a misconception among some South Africans that private hospitals in the country are reserved only for medical aid members. This is untrue. South African private hospitals are open to the general public, irrespective of whether you belong to a medical aid or not. However, these are private enterprises and the service they offer are not free. Many patients who are not critically ill are therefore often turned away as they are unable to pay for the services at these hospitals or do not have the financial ability to at least pay an initial deposit. It is these situations that have fuelled the misconception that private hospitals in South Africa are only for medical aid members.

Affordable Private Hospital Care

The bottom line is that private healthcare in South Africa is not cheap. Neither is it in most other countries, even other developing nations. Private hospitals, as is the case with private clinics and private doctors, offer a higher quality service in most cases than do state institutions and government doctors. This is a rather broad statement as there are many competent healthcare professionals in the state employ and some world class government facilities. However, this is few and far between. It is not just about the medical care but also about the location and shorter waiting times within these private facilities. As with any product or service, you pay for what you get and patients in private hospitals expect and receive a better level of medical care and overall service.

Unfortunately these private hospitals are not affordable for the majority of South Africans. Over 60% of South Africans still use state facilities and service providers. In some areas, the government hospital and state-employed doctors and nurses are the only healthcare options. Choice is therefore limited. While state facilities offer medical care for free or at most a small fee for administrative purposes, private hospitals charge medical aid rates as outlined in the National Health Reference Price List (NHRPL). Some hospitals do offer a slightly discounted rats for non-medical aid patients who can afford to pay cash but it is nevertheless expensive.

For the average South African, private hospital care is not affordable by any means and therefore often not accessible without medical aid cover. Non-medical aid patients with the financial resources to pay for the services in cash will also often agree that private hospitals in South Africa are expensive.

Cost of Private Hospital Treatment

The cost of medical care in a private hospital varies. Unlike with a government hospital there is no single administration fee for all patients irrespective of your medical condition. Similarly, pensioners, children on child support grants and the disabled cannot expect free treatment in private hospitals. In most cases there is not even a discounted tariff structure for these individuals within the private hospital setting. Patients who are not on medical aid therefore have to pay an upfront deposit. This can vary depending on the hospital and the medical condition that needs to be treated. It is sometimes as low as R3,000 and as high as R15,000. Patients who in need of bypass surgery for a heart attack may have to fork out a cash deposit of R50,000 or more for private hospital care.

However, the costs do not end there. These deposits are just a small surety for the medical bills you will accrue within the hospital. Depending on your city, the private hospital in question and the ward, a hospital bed costs between R1,200 to over R2,000 per day. This simply includes the cost of staying in hospital for each day and meals. Consultation fees for doctors and other healthcare professionals as well as the medication administered and disposable items used on you will be additional costs. Patients who require surgery have to also realise that they are billed for the time in an operating theatre apart from the surgeon and anaesthetists fees. Medical investigations such as blood tests, CT scans, MRIs and ultrasound are other additional costs.

Payment Plan for Private Hospitals

Private hospitals in South Africa are not obliged to provide payment plans for non-medical aid patients who do not have the cash upfront. And almost none do. You are required to settle your bill upon being discharged and it is not uncommon for private hospitals to sometimes insist on part payment even while you are still hospitalised and undergoing treatment. All too often non-medical aid patients skip on the bill leaving both the hospital and service providers at a loss. Some private hospitals will allow a non-medical patient to pay the bill within 15 days or more from the time of being discharged but this is only in certain rare situations.

Critically ill patients can expect medical service at a private hospital but only to the point where they can be stabilised and transported to a government hospital should they not be able to afford private care. Most private hospitals are not negotiable on promises of future payments without a person providing a deposit and sometimes even a credit card with funds to access. Medical aid patients should not be fooled either. They are often also required to pay a deposit, albeit very small, when being admitted to a hospital.  Medical aids may not cover all hospitalisation costs and it is therefore vital for medical aid members to clarify these issues with both their medical scheme and the hospital at the outset.

Hospital Cash Plans for Private Hospital Care

A popular insurance product on the market these days in the hospital cash back plan. Here insurance companies will pay the beneficiary a certain amount of cash for each day in hospital. This is not a medical aid. Neither is it a hospital plan medical aid. In fact, a medical aid and a hospital cash plan are two different financial products entirely. A hospital cash plan is simply an insurance product to cover you for your personal expenses. Private hospitals do not view these hospital cash back plans as a medical aid and do not accept it as suitable surety for your upcoming bills. You will still have to pay a deposit and settle your bill immediately upon discharge.

However, you have some protection in that the payment from a hospital cash plan will help you cover the hospital expenses you incur. It is of limited benefit in serious ailments like a heart attack. In this case, a patient can clock up a bill of R200,000 in less than 10 days of hospitalisation. Top level cover on these hospital cash plans may at most cover you for about R5,000 per day which in 10 days equates to R50,000. You will still need to pay for the shortfall from your own pocket. It is therefore important to realise that no other financial product in the South African market can replace a medical aid and give you access to quality medical care like within a private hospital.