About Hospital Plans and Medical Schemes
Many young South Africans are asking themselves if they should bother with hospital plans and medical schemes. If you’re faced with deciding between hospital plans and medical schemes you need to know that there are two options when it comes to hospital plans. There’s the hospital plan offered as short-term insurance and the other that falls under medical schemes and is regulated by the Council for Medical Schemes (CMS) like a medical aid policy. Taking the former is quite risky and will probably not give you full value for your premiums.
Difference between hospital plans and medical schemes
For one, short-term hospital plans offer limited cover and if your hospitalisation expenses get too high, you will more or less be left on your own. And even when you’re disappointed with the claims, you will have nowhere to lodge a complaint. Unlike medial schemes that have CMS, there is no regulatory body that governs these kinds of hospital plans. Those offered by medical schemes come under the jurisdiction of the CMS and as such are required to include Prescribed Minimum Benefits (PMBs).
Beware of health insurance
Short-term insurance hospital plan providers can not only decide to cancel your cover whenever they see fit, they can hike your premiums if they think your claims are too frequent. This cannot happen of you’re dealing with a medical scheme thanks to the aforementioned regulation. And such security need not come at an extra cost. You can find a medical scheme-backed hospital plan that costs as much as those offered by short-term insurers if you shop well enough.
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Tips when choosing a hospital plan
Besides opting for medical scheme hospital plans, here are other factors you should take into account:
Age: It is generally more advisable to subscribe to a hospital plan while you are still young and active (in your 20s) as your premiums will generally be lower. You will pay less, even as you age, than someone who took up the plan for the first time in their forties, or who had a policy then abandoned it and now wants to subscribe anew. The older you are, the higher premiums for hospital plans are.
Size matters: Big medical schemes like Bonitas and Discovery Health are the better option when shopping for a hospital plan. They are more stable and have a bigger pool of funds to draw from. Smaller insurers are always at risk of folding or being bought out by bigger firms.
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All info was correct at time of publishing