Medical Aid vs. Hospital Plan


It is important for you to understand the difference between hospitals plans that are part of medical schemes and the ones that are sold by insurance companies. One difference is that a hospital plan is not regulated by medical councils and they offer a limited cover. In addition, the cover may be cancelled at any time especially when your claims have become too high. This means that since the plan is not regulated, you will have nowhere to lodge your complaints if you want to dispute your claim.

Medical Aid Schemes

By law, medical schemes will be required to offer plans having prescribed minimum benefit. This is going to cover a number of chronic medical conditions including HIV, heart conditions and diabetes. However, even if you do not have enough money to take out medical aid, you can still find a hospital plan that is affordable and still provides you with greater coverage, and most importantly, it will be guaranteed. Medical schemes may increase your monthly premiums or terminate your cover based upon your claims history.
A medical aid has penalties if you join as a first timer and you are past 39 years of age. Even if a person took a break from being a member for over 90 days, these fees may still be applicable and they are applicable for life. Even though a person chooses another medical scheme, the late joiner fees may still be applied. For instance, if you joined the medical scheme when you are 40 years old, you will be asked to pay 10 percent more compared to other members. A fifty year old may be asked to pay 20 percent more than the other members of the same medical scheme. This means the earlier you join a medical scheme, the better for you.

Hospital Plans

The hospital plans are also referred to as an entry level medical aid plan. This is because it is a more affordable option to choose. With medical aid, you might end up having to pay crazy amounts of money as monthly premiums. In addition, a medical aid scheme will often leave you in a quandary when you need it the most. This is because of the restrictive regulations that a person needs to follow.

The hospital plans are suitable for fit and healthy young people since it costs less and they need fewer medical services. There is selective cover and applies only when you require major surgery, after being involved in an accident and when you have spent the night at the hospital. On the other hand, with medical aid, you pay more money but you will have peace of mind knowing that your cover, claims, surgery and hospitalization are sorted.

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