Health insurance South Africa is a constantly developing and evolving area, where new legislation and government programs mix together with over 100 private and public medical aid schemes. The whole subject can be a very confusing one with so many schemes available, although what is not in doubt, is the need for good private health insurance. The state hospitals do their best, but they are suffering under budgetary cuts, making it essential to take out private insurance to ensure prompt attention and good care during any stay in hospital.
The types of health insurance South Africa can be broadly put into two categories. These are medical aid plans, and hospital plans. Of course, there are some policies available which may stretch over to cover the ground between the two categories, but it is easier to classify them this way.
Medical Aid Plans
Medical aid plans are a way to ensure that any medical bills that are incurred during a hospital stay are covered. They normally have higher monthly payments than hospital plans, and can cost upwards of R400 per person per month, and up to R2000 per family of four per month. As with anything, you get what you pay for with these schemes. Many of those at the lower end may have limits on what they will payout for, with the very cheapest ones stating that they will only pay 80% of the total costs of any hospitalisation. The more comprehensive policies will include local doctor and dentist fees as well as a full range of hospital fees.
Hospital plans are a valuable addition to the health insurance South Africa market. They generally cater to both the younger working population and those on a more limited income. The monthly fees are far lower than those of a medical aid plan, and can start from as low as R200 per month for the more basic fees. The main difference between this and a medical aid plan, is that instead of a guarantee of bills being paid, instead, a daily income is guaranteed during any stay in hospital. The amount varies between policies, and can range from R2000 to R5000 per day. This income can then be used to pay for the hospital bills. It must be noted, though, that it may not cover all of a bill.
Which one is best?
This is an impossible question to answer, as they both have their benefits and drawbacks. However, they do compliment each other brilliantly. So, for example, a person with both medical aid AND a hospital plan would have their hospital fees covered, as well as a daily income. This income might in some circumstances be vital if the person in hospital was the main wage earner from a family. A medical aid package by itself might be more suitable for a young family, or someone that expects to have hospital visits, whilst a hospital plan would make more sense for fit and healthy people in their early-twenties.
Whichever health insurance South Africa you decide to go with, it is important to shop around and get as many quotes as possible. It is as equally important to read what the details are in those quotes. The very cheapest policies often have more limited cover, that in a time of need, may not be up to the task. It is far better to pay a few Rand more each month and have the peace of mind that comes with knowing your family and yourself are covered in the case of an unthinkable incident that involves injury or illness requiring hospitalisation.