Hospital Plans

In order to provide more affordable medical aid some medical aid schemes have come up with hospital plans. These plans will save you money but will limit the health care you receive to in-hospital treatment.

What is a hospital plan?

A hospital plan is a form medical aid. There is a snag here. Firstly, it only pays for your medical cover while you are in hospital. So when you are out of hospital you have to pay for the medical cover out of your pocket.

The pros of hospital cover:

  • There will be cover should you need any treatment in hospital
  • Medical Schemes Act requires hospital plans to provide treatment for the list of 270 prescribed minimum benefit conditions as well as the 25 chronic conditions listed in the chronic conditions list.
  • It is important to note that only hospital plans offered by registered medical schemes are obliged to Hospital Plans South Africacover treatment for these conditions. For this reason it is advisable to take out a hospital plan with a medical aid rather than an insurance company.
  • Hospital plans have to pay for life threatening emergency medical conditions.
  • Some medical schemes include a limited savings account to assist you with some of your day to day medical costs.


The cons of hospital plans:

  • In most cases you are have cover for in-hospital treatment.
  • The treatment cap at scheme rates and you might have to pay in the difference.
  • Some hospital options have annual limits, should you surpass these limits you are required to pay any additional hospital costs yourself.
  • You might have to only use a specific set of network hospitals.
  • In some cases there may be co-payments.


Who should consider getting hospital cover?

  • People of good financial standing that can afford to pay day to day medical costs from their pockets.
  • Young and healthy persons that only need hospital cover in case of an emergency.
  • Persons with limited financial needs, the hospital option can cover you in case of hospitalization and you can make use of the clinic system the government health provides.


Are there any possible alternatives to hospital plans?

  • Your best option as an alternative to a hospital options is to consider a network option.
  • The network option might be cheaper, but will limit you to network service providers.
  • With a network option you will receive day to day cover as well.


As with all medical aid options it is important that you do your homework when you consider hospital cover.

Make sure you understand the benefits, annual limits, scheme rates, rules and the cover you receive before you purchase any medical insurance.

Also choose a scheme where it is possible to upgrade to a bigger plan any time of the year, this will allow you to have additional medical aid plans available should you suddenly need more extensive medical cover.

Even though hospital plans might be a cheaper alternative it may not always the better option, choose medical cover based on your medical needs and what you can afford.


Go here to get a health insurance quote online



All info was correct at time of publishing