What exactly are hospital plans? Most folks realize that traditional health insurance is risk-based, wherein members only pay a fixed monthly premium for health care they receive. However, this coverage does not offer as many options like those provided by Hospital Plans. It only pays out in certain situations and comes with certain advantages. If you’re thinking about getting insured in South Africa, here are several things you should know to help you choose the right plan.
Hospital Plans in South Africa generally covers the entire range of healthcare services provided by hospitals in the country. However, there are a few differences in the various plans, such as the choice of service types and the extent of coverage. Generally, all hospital plans cover the major categories of medical care: diagnostics (Rx), critical care, surgical operations, hospital admissions, discharges, physiotherapy, occupational therapy, psychopharmacology, and patient transport. However, your doctor may opt-out of some of these services if he deems them to be unnecessary for you. For instance, if you are diabetic and require regular medication, your doctor can opt-out of a blood test on discharge or an assessment of your condition after discharge.
As with all other South African hospital plans, coverage includes basic family healthcare services such as maternity leave, immunizations, childbirth, and immuno-compromised diseases, treatment for infectious diseases, and hospitalization. It is also important to note that, depending on the plan, hospitalization may be covered after one week from the date of illness. On the other hand, if you are travelling abroad and get ill during your trip, you will have to get yourself immunized before getting yourself admitted to a hospital here. The extent of your hospitalization is determined by the South Africa Ambulance Service, which will decide how many days you need to be admitted to the hospital. Several plans also cover other specific healthcare issues, including after-care treatments.
The plan is designed to give greater flexibility to both family and domestic travellers going to or leaving South Africa. Most hospitals in the country are well equipped to handle cases of medical emergencies, but if they happen to be out of reach due to distance or transportation difficulties, emergency departments here will step in to provide you with assistance. Some of the state hospitals in South Africa also offer specialised emergency care facilities. As most tourists are aware, most of the state hospitals are renowned for their medical procedures, but some of the private hospitals in South Africa are slowly coming up to compete with the established names.
If you are travelling outside the country, hospital plans in South Africa provide cover for expenses not covered by public healthcare services, including doctor and hospital fees, transportation to and from the private healthcare facility, and other emergency medical expenses. While there are public healthcare facilities in southern Africa, most are far from the capital city, especially in rural areas. If you do travel outside the metropolitan areas, it is essential to carry your healthcare insurance, which can be a costly affair should an emergency arise. Private healthcare providers, on the other hand, will not only cover your treatment expenses but also provide cover for your family members – especially if any are seriously ill or injured.
For many medical tourists, hospitalisation cover provided by private health insurance companies proves to be invaluable. While they can visit the hospitals of their choice with peace of mind, paying the premiums on their hospital plan means that if they need care outside the local jurisdiction, they will not have to worry about meeting hospitalisation costs. If a trip to South Africa is on the cards, finding the right hospital plan now will ensure that you can relax and enjoy your holiday.