Different types of hospital plans are available. There is a difference between hospital plans and medical schemes. With hospital plans you have to cover almost all of your day-to-day out-of-hospital costs yourself and they also cost less compared to medical schemes.

Consider your family’s medical history when wanting to join a medical scheme. Also keep in mind that the onset of a sudden chronic condition could bankrupt you. Joining a medical scheme later could cost you more, as you might have to pay more as a result of your age. You can also be excluded according to the law, for up to 12 months, from treatment for a particular condition. If all people could just join a medical scheme when they got ill, all schemes would soon be bankrupt.

Many medical schemes have been adversely affected by the departure of younger and healthier members from full medical coverage options to low-cost hospital plans. This departure has meant that the cross-subsidisation of older, sicker members by younger, healthier members has been reduced. This has contributed to an increase in membership fees. Other reasons for medical inflation include the government’s regulations regarding reserves of medical schemes, the list of Prescribed Minimum Benefits, and the fact that medical schemes may no longer turn down new applicants. The cost of imports of medical equipment is also affected by currency fluctuations. All of these regulations are aimed at protecting medical scheme members, but a few of them have contributed to high medical inflation.

Types Of Cover

Being a medical scheme member or being on a hospital plan does not automatically mean that your hospital expenses are covered completely. Many schemes and hospital plans have specific regulations on organ transplants, cancer treatment, ambulance and emergency services, dental surgery, medical appliances, HIV/Aids treatment and artificial limbs, among others. You could find yourself running out of benefits halfway through cancer treatment. So check the regulations regarding overall limits and treatments that are not covered. It is absolutely essential that you know these things. Speak to your medical broker if you require more information.

Even hospital benefits on full medical schemes have certain limits, so this is another thing which should be considered before joining up. Some schemes have low hospital limits; this is therefore insufficient cover if a member and three dependents were all to be involved in the same accident. If your finances are tight and you have a choice between either a hospital plan or no medical cover at all, the hospital plan is obviously preferable. But if you are in a position to afford full medical scheme membership, it does provide peace of mind, as many of your day-to-day expenses are also covered. Many people on hospital plans find that if they add up what they spend on day-to-day medical expenses, it cancels out the difference in price between the hospital plan and the full medical scheme membership.