What You Need to Know About Hospital Plans
Hospital plans are becoming more and more popular among South Africans as the cost of medical cover becomes unmanageable. That’s why you need to know about hospital plans.
People are increasingly opting to go for hospital plans that cater for the cost of your medical bills during hospitalisation. It is important to note the difference between such hospital plans and those that pay out cash for every day you spend in hospital (hospital insurance). The latter only cater for your hospitalisation, not for the treatment you receive. You therefore need to read the fine print when signing up.
Know about Hospital Plans vs Medical Aids
Most people get excited at the lower premiums of hospital insurance and forget to find out exactly what it covers. They see that they can get cover while paying less than half of what a full medical cover costs. Assuming that a hospital plan will cater for all your medical expenses is a dangerous assumption that could leave you facing huge bills when seeking treatment, despite having paid your premiums faithfully.
Note: Hospital plans from registered medical aids (Discovery, Medihelp, Bonitas, etc.) are like medical schemes in that they are regulated by the Council of Medical Schemes but hospital insurance from insurance companies do not fall in this category.
But unlike a medical plan that 
covers out-patient costs, you need to be admitted to hospital to enjoy the benefits of a hospital plan. But instead of paying only for your stay in hospital as hospital insurance does, a hospital plan from a medical scheme will cater for the treatment of up to 26 chronic ailments. This feature was added to reduce the need for hospitalisation. Medication for the prescribed illnesses will be paid for by the plan. Like we said, out-patient costs will have to come out of your own pocket if all you have is a hospital plan. This kind of cover is therefore great if you are healthy and generally fall ill rarely. But if you develop a complication that alters this, be ready to change your cover.
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When signing up for a hospital plan be sure to inquire which kind of hospitals are included in the cover.
Different Prices Mean Different Benefits
Lower-cost covers generally have a specific network of hospitals that you have to visit but the more expensive hospital plans will let you choose from a variety of private hospitals. Depending on the kind of plan you have subscribed for, payment for your hospitalisation and medication while there will be paid for in full. This is because healthcare providers and insurance firms have agreed-upon rates. Private practitioners on the other hand can charge up to three times what your hospital plan can pay out. Even those who have full medical cover end up having to go back into their pockets when seeing certain specialists. The best you can do if you find yourself needing to see a specialist is to take up gap cover.
Conclusion
Besides medication, some hospital plans also will pay for some forms of specialist treatment. Pap smears, mammograms and even colonoscopies can be paid for by certain hospital plans. Speaking of medication, you can keep your costs low by using pharmacies recommended by your hospital plan provider. Know about hospital plans to protect yourself.
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All info was correct at time of publishing