Hospital Indemnity Plans

December 15, 2021

Many folks do not understand what hospital indemnity plans are. They equate it to a hospital plan or medical scheme.

But this is not the case. There is a clear difference between the two types of policy.

Hospital indemnity plans cover the shortfall between medical aid and the actual cost of medical treatment in South Africa.

Some of the costs your hospital plan does not cover. For instance, while it may pay for the bed you sleep in when admitted, the cost of theatre space, if you’re having an operation, may not be covered.

Medical aid members can request a medical gap cover quote
by completing and sending the form on this page

Keep Your Eye on the Ball when It Comes to the Various Options Available out there

Depending on the agreement with the insurer, your hospital indemnity plan will pay you a fixed amount of cash for those expenses.

For instance, you could get R2,000 per day to cater for these expenditures. The cost of nurse care and similar outpatient care are other needs hospital indemnity plans can cover.

Can Anyone Take Out a Hospital Indemnity Plan 

You must be a medical scheme or hospital plan member to be eligible for a hospital indemnity plan. It will still save you a lot of out of pocket expenses when seeking casualty or outpatient treatment.

The beauty of taking out this kind of cover is that you are not restricted to the insurance provider’s network of healthcare providers. You get to choose the hospitals and specialists for treatment.

All you need to do is make sure your hospital indemnity plan will be adequate to cater for the expenses involved.

Restrictions on Hospital Indemnity Plans

The need for hospital indemnity plans has been precipitated by the numerous restrictions conventional medical plans come with these days.

South Africans are therefore on the lookout for plans that will fulfil their medical needs without the limitations. Apart from the restrictions, the two kinds of medical cover are quite similar.

If you find a medical aid plan and indemnity plan that are very alike, which one should you choose?

Well, you need to weigh the obligations, benefits and limitations of each very carefully before arriving at a decision. And also remember that it is possible to have both these kinds of covers simultaneously.

In fact having both would be the best as each would offset the other’s limitations, offering you more comprehensive medical cover.

You can have a hospital indemnity plan for your outpatient needs and a hospital plan to cater for your stay in a hospital. To get the best out of both covers make sure you fully understand the benefits and limitations they come with before you sign up.

If possible, get unbiased advice from an insurance expert or have a legal representative look the contracts over before you agree to anything.

Medical aid members can request a medical gap cover quote
by completing and sending the form on this page

All info was correct at time of publishing