Medical aid vs. hospital plan: A few thoughts on how to choose what’s right for you

In life, there are many important decisions you will need to make, one of which is deciding between a medical aid or a hospital plan. Both offer certain advantages and disadvantages, such as covering emergency surgeries or offering daily GP visits. Choosing which one is right for you can be a hard decision, so comparing hospital plans in South Africa prices can help. Below is some useful advice on how to choose between a medical aid and a hospital plan based on what is right for you.

Consider your medical needs

This is the most important step on your journey to deciding. You will need to take into account what your medical needs are: do you need to have regular doctor’s visits or use chronic medication? A medical aid is ideal for this type of situation.

If you feel that you are healthy enough, and only visit the doctor once or twice a month, then a hospital plan is ideal. Both of these options have late joiner fees, so it is best to address your health needs now and sign up before it is too late. Make a list of all of your health needs and go over them in order to ascertain whether you need a medical aid or simply a hospital plan.

How are your finances?

Medical aids and hospital plans in 2018 cost money, but many offer highly affordable rates. Before you decide on which is right for you, you will need to look at your finances. If you have a low monthly income, you will not be able to afford high monthly contributions.

If you decide on a hospital plan over a medical aid due to the hospital plans in South Africa prices, then you will need to be sure your spouse and children are covered, and what your monthly contributions will be. Investing in some form of medical coverage is important at any stage of life, especially if your finances allow for it. Draw up a monthly budget and see whether or not you are able to afford to contribute to a medical aid or a hospital plan.

Find out about exclusions

There is one aspect of both hospital plans and medical aids that you need to know about before making a decision: what are the exclusions? Some schemes may exclude you from claiming for certain conditions for a limited period of time (not longer than one year).

If you are joining a hospital plan or medical aid for the first time, you may not be able to claim for day-to-day GP visits in the first three months. Compare the exclusions of best hospital plans in South Africa and the best medical aid plans, being sure to take note of any conditions you or a family member might have. If a particular plan or scheme excludes them, it may not be the best option for you.

Carefully examine the benefits

On paper, a hospital plan or medical aid might look absolutely brilliant, offering affordable coverage and benefits that meet your needs. You will need to find out if you have a Medical Savings Account (MSA) and how much that is. If it is too low, then you will find yourself contributing more towards hospital stays and doctor’s visits.

You should find out which hospitals are part of the hospital plan network you are looking at, because  if you find yourself at one which is not a part of this network, then you might have to pay an exorbitant co-payment. For medical aids, find out what they cover for emergencies and prolonged hospital stays and be sure to look at one that covers 200% of the usual medical scheme rates. Factor in the cost of GAP cover when you look at monthly contributions and benefit offerings,  too.

Check with your doctor or hospital

If you changing hospital plans or switching medical aids, ask your doctor’s office or local hospital whether they have had difficulties in dealing with specific options, such as late payments or too-little coverage.

Knowing that a hospital plan is favoured by a hospital plan close to you can help to ease decision making, as can the fact that your doctor prefers a certain medical aid that you were considering. If you find that one specific hospital plan has given trouble to numerous hospitals, then it is best to disregard this option. A medical aid that gets bad reviews from doctor’s offices is also one to steer clear from, so having this advice to hand will help immensely in choosing one for your needs.

Weigh the pros and cons

When deciding between a medical aid and a hospital plan, it is best to weigh out the pros and cons. Start by looking at medical aid and hospital plans in South Africa prices, then move onto the benefits lists and MSA offerings. Remember that while the contributions might be affordable, the benefits list might not meet all of your needs. Assess your current financial situation before you make any decisions and remember to inquire at hospitals and doctor’s offices for advice.

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