Once in hospital, the medical bills can begin piling up quickly. You should not have to compromise on your medical treatment or go into distress at the thought of footing a hefty medical bill. This is where a medical insurance policy can help!
A medical insurance policy will pay out daily lump sums in the event of hospitalisation. This will keep medical debt to a minimum and allow you or your loved ones to focus on healing. Alternatively, you could find yourself dipping into your savings or taking out a medical or personal loan.
Gems
Medihelp
BestMed
Fedhealth
Affinity Health
Key Health Medical Scheme
Genesis Medical Scheme
Essential Med
One Plan
Discovery
Finding the right medical insurance company can be tricky if you don't know what you're looking for or find financial terms confusing. Additionally, the process of finding an appropriate insurer can be lengthy and tedious; it's easy to become fatigued or feel compelled to jump into a contract.
Here at BudgetGist, we understand that the process of finding an insurer that fulfils your needs can be daunting. Our handy guide can help you make an informed decision about your medical cover. That’s why we pride ourselves on being South Africa’s information hub for all things related to finance and money.
Medical insurance is also known as health insurance and provides financial compensation for in-hospital expenses and related medical cover. The actual extent of your cover can depend on your insurer, and you may be able to find health insurance that covers a wider range of medical expenses. These expenses could include dental procedures, individual doctor appointments, specialist cover, and medical prescriptions.
Like many other forms of insurance policies, you will be required to make monthly premiums to your insurer in return for medical cover. Your health insurance premiums may depend on your age, occupation, risk factors, and affordability.
One benefit of medical insurance is that you may have access to a wider range of service providers for medical treatment, including private healthcare providers.
Another benefit of health insurance is that you have control over the allocation of funds and payment of bills. You can decide how you wish to use your daily lump sum. You could put it towards your overall hospital bill or once-off expenses like prescription medication.
You are not covered for specific procedures, types of treatment, or restricted to a specific hospital in your area. You can choose your hospital and make an informed decision regarding your treatment without worrying about getting a medical aid claim approved.
There are a few health insurance companies in South Africa such as Liberty, EssentialMED, Sanlam, Momentum and Affinity Health.
Terms and conditions may vary across insurers. For example, Liberty requires you to be a member of a South African medical scheme to qualify for their Liberty Gap Cover. Additionally, Liberty offers medical cover to your entire family, with the option of a premium waiver in the event of your death or disability. This means you and your family will continue to have access to health care and medical treatment even if they no longer have the financial means to pay for medical cover due to your loss of income.
Another popular medical insurance provider in South Africa is EssentialMED. One benefit of EssentialMED's medical cover is that it is more flexible in terms of getting to choose what your coverage. EssentialMED's cover ranges from day-to-day and hospital to accident and emergency. This insurer also offers dread disease and funeral cover.
An insurance company that specialises in medical cover is Affinity Health. With Affinity Health, you are given the option of day-to-day cover and a hospital plan. A unique benefit is their unlimited cover for doctor appointments and dental consultations.
While medical insurance and medical aid schemes may seem very similar, these financial products are vastly different. Some of the key differences between medical insurance and medical aid include their coverage, cost of premiums, eligibility and tax benefits.
Due to the unique benefits of both financial products, some people may opt for both a medical insurance policy and a medical aid plan.
Medical aid offers a wider range of coverage, and it may be easier to get your application approved, compared to medical insurance which has a stricter approval process. Additionally, medical aid contributions are tax-deductible.
Medical insurance pays out a daily lump sum of money directly to you for each day that you are hospitalised. You are directly responsible for using the money to pay for medical or related daily expenses.
The lump sum of money does not depend on the nature of your hospital visit and may not account for prolonged medical bills such as follow-up physiotherapy or occupational therapy appointments. However, some insurers may offer additional cover as a value-added benefit to your existing policy.
With medical aid, your service provider or hospital will send a claim directly to your medical aid company. Your medical aid provider should give you a list of service providers and hospitals that they are affiliated with, as well as the types of procedures covered. It’s important to note that you may only be allowed to make claims up to a maximum amount annually.
Depending on your medical aid provider you may be required to make a co-payment. This means your medical aid will only cover a percentage of your medical bill and you are liable for the excess amount.
A benefit of medical insurance is that it can be used to pay for medical and related daily expenses if there is a shortfall in your medical aid coverage. Medical insurance premiums are usually cheaper than medical aid. If eligible, more people may be able to afford medical insurance.
Medical insurance can help prevent you from going into debt by giving you a financial cushion to pay for medical bills whilst hospitalised. It can allow you peace of mind and access to quality health care.
Medical insurance can be ideal if you anticipate a shortfall in your medical aid payments. Before choosing an insurer, you may find it useful to make a list of your needs, including non-negotiable factors. Websites like BudgetGist can help you narrow down your choices by comparing quotes, terms and conditions.
Going into medical debt can be scary. It can negatively affect your credit score and result in complicated debt collection processes. With various medical insurance options available in South Africa, you can find the right medical insurance policy that suits you and your family's needs and your budget. Luckily, BudgetGist is here to help! We are South Africa's information hub for all things related to finance and money.
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