The Difference Between Health Insurance and a Hospital Plan

    March 6, 2017

    There is quite a difference between hospital plans and health insurance.

    Hospital plans offer much more cover than health insurance does.

    But, they come with a higher monthly premium.

    While Health Insurance will offer no-claim bonuses and cash-backs, hospital plans will cover 100% of hospital treatments, provided patients use a listed health expert.

    Hospital plans cover more

    Many hospital plans cover an unlimited number of treatments.

    Treatment for health crises’ such as car accidents, for example, could end up costing more than R100 000.

    Costs could keep rising if patients have to undergo operations and receive treatment in intensive care units at private hospitals.

    Hospital plans cover their members for 100% of standard medical aid tariffs. Hence, members can rest easy and don’t need to stress about money in times of need.

    Albeit, they do not cover daily expenses, such as visits to doctors and dentists, etc.

    Health schemes pay the cost of health treatment straight to the service provider, easing members from the stress of red-tape involved with treatment.

    Note: Health experts may charge far more than the set scale of tariffs. Hence, members must pay the excess amounts if they are billed more than the Medical Scheme Tariffs (MST). Albeit, they can avoid this by getting gap cover; an add-on that pays the difference.

    Difference Between a Hospital Plan and Medical AidSo what’s the difference?

    Several financial providers such as insurance companies and banks offer products termed as “hospital plans” or “cash-back plans”.

    However, users would be well advised to read the small print of their contracts before putting pen to paper.

    Exclusion and limitation clauses are inherent in these products and people should fully understand all the conditions to avoid any future nasty shocks.

    Hospital insurance offers to pay a set daily amount for treatment.

    Others specify certain “cash-back” payments after some days in the hospital.

    Some also include set payments for certain treatments.

    Unlike medical aid hospital plans, private health insurance gives members the freedom to select hospitals of their choice.

    Also, the plan pays excess amounts directly to the policyholder if treatment costs less than the standard medical tariffs.

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    All info was correct at time of publishing