Switching to a Hospital Plan from a Full Medical Aid

    December 7, 2015

    In South Africa, we know just how expensive it is to belong to a medical aid. It is a privilege and benefit that not all can afford. Many times those who are on medical aids question their cover, particularly when they are battling financially. They then consider switching to a hospital plan from a full medical aid.

    Some people have decided on switching to a hospital plan from full medical aid cover. If this is something you have been considering, you need to ponder your decision very carefully before switching to a hospital plan just like that.

    Battling Financially? Switching to a hospital plan could be a good choice

    There is no doubt that switching to a hospital plan offers less cover than the comprehensive cover of a medical aid. Sometimes however, the higher cover ranges from a hospital plan can offer you more than the lower cover ranges from your medical aid plan.

    Hospital plan cover will not give you out-of-hospital day to day medical costs, consultations with your doctors and other treatments like scans and tests, etc. You have to realise that you will pay Switching to a Hospital Planfor what you get. If you need the benefits of a full medical aid package, it will be more costly than the hospital plan only.

    Naturally if money is tight, it might be better switching to a hospital plan with your medical scheme from a higher medical aid option. Always remember that it is better to have any kind o cover than no cover at all. With private hospital care in South Africa being so very expensive, the least you can do for yourself is belong to a hospital plan.

    There’s a Time to Make Your Change

    You need to remember that if you are on a medical aid plan and want to opt for a hospital plan only, some medical aids will not allow you to change over in the middle of the year – whether you are upgrading or downgrading.

    You might have to wait until the end of the year to make your change. You can however resign from your current medical aid scheme and join another scheme of your choice. Remember to be careful when doing this, because you don’t want any breakage in your cover. That means you won’t have protection. You need to plan carefully so that resigning from one gets you started off immediately with the new scheme.

    When Switching to a Hospital Plan Avoid Interruptions

    As an existing medical aid member, you will be able to get past the normal waiting periods when you move over to a new scheme (only if your cover from the one to the other is not interrupted). Find the scheme that suits you best and handle this transition with great care, ironing out all the necessary details with your new scheme.

    Acquaint yourself with all the implications as well as the pricing structures when you move over. You will complete medical aid scheme forms and then wait for the approval, not forgetting to inform your existing scheme of the change over.

    The main thing is to Ensure No Break in Membership

    Sometimes switching to a hospital plan from one medical aid scheme to another is not just plain sailing. It can be that you will be still be billed by your old medical aid even despite being a member and joining the new medical aid scheme.

    Obviously your most important concern if you are considering changing over will be the continuity of the cover. A word of advice; remember you cannot belong to more than one medical aid scheme in South Africa at the same time; it is illegal.

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    All info was correct at time of publishing