What is a Hospital Plan?

A lot of people do not understand hospital plans as a medical aid option and what they offer you. We will take a closer look at hospital plans. There are 10 factors you should consider when you plan to purchase a hospital plan. But what is a hospital plan?

Hospital plans in general are a more affordable medical aid form, but you have to consider the amount of cover you receive when you do purchase a hospital plan.

What is a hospital plan?

A hospital plan can be described as a medical aid plan supplied by an insurance company or a registered medical scheme that covers your medical costs while you are a patient in hospital. This is a risk-based type of insurance, where you insure your health against the risk of you getting sick or injured. You have to pay a monthly premium for this cover.

10 Things to look out for when you consider the purchase of a hospital plan:

1. Affordability: most hospital plans are cheaper medical aid options; however the cheaper options might not be the best ones.
2. Scheme rates: All medical schemes have a set rate at which they pay claims. Find an option that pays 100% of scheme rates or more. This will mean that, should you have to pay the difference between the scheme rates and what the hospital charges, the costs will not be too great.
3. Overall annual limits: Try and find a hospital plan with an unlimited overall annual limit. This might costyou more but it will give you peace of mind that your cover will not dry up in the middle of the year.
4. Exclusions and waiting periods: By law, all schemes may place exclusions and waiting periods on new members. This excludes prescribed minimum benefits, however, in these costs.
5. Casualty cover: There are plans that have additional casualty cover. Again, this might cost you a bit more, but you will have cover in case of a medical emergency.
6. Medical savings accounts: Find a hospital option with an additional medical savings account, this can either help with the gap payment or act as additional day cover.
7. Prescribed minimum benefits: all of the schemes must by law pay for the list of 270 conditions including 25 chronic conditions. Schemes are not allowed to reject claims for these conditions.
8. The benefits: Look for a plan with benefits that cover your needs. For example, if you have a family history of cancer, find a plan with a higher oncology benefit.
9. Co-payments: some plans require co-payments for day procedures and certain other procedures in theatre.
10. Take home medication: Not all of the plans cover take-home medication. Be sure to choose a plan that covers this otherwise you will be required to pay for this yourself.

Before any purchase ask yourself: what is a hospital plan, and will you receive all the cover you need?

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All info was correct at time of publishing