Medical Insurance vs Medical Aid

Medical Aid Medical Insurance
Compare Medical Aid and Medical Insurance in South Africa

Medical Insurance, also known as Health Insurance, can often be confused with Medical Aid.

It is important to note that there is a distinct difference that can be seen in the way that medical expenses are covered within the two options.

What is Medical Insurance?

Medical insurance, also known as health insurance, is understood as a policy that offers coverage against medical expenses that result from a health emergency. With medical insurance, should you fall ill or suffer an injury and need medical attention, your medical insurance will pay out an amount directly related to covering the costs incurred due to this medical emergency.   

What is Medical Aid?

Medical aid is a policy taken out whereby you pay a monthly premium to allow you to have medical assistance when needed and not feel the financial burden of such an event. Medical aid is convenient for day-to-day doctor visits, dentist visits,s and hospital admission.

Why do I need a Medical Insurance plan?

A medical insurance plan is seen as taking out insurance on your health and is necessary as it provides a form of protection, should you develop an unexpected serious illness or be involved in a serious accident that directly affects your health status. This medical insurance will assist in the payment of high unexpected costs incurred whilst in hospital directly related to this event.

Why do I need a Medical Aid plan?

A medical aid plan is necessary when you need to cover day-to-day medical expenses such as a visit to the doctor, dentist, or when you need to be admitted to the hospital.

Why is Medical Insurance in South Africa important?

Medical insurance in South Africa is important to cover costs for medical procedures that come at a higher cost which some medical plans will not cover when in hospital. It is also seen as a more affordable alternative to medical aid.

Why is Medical Aid important in South Africa?

Medical aid is important to cover costs for day-to-day medical procedures that arise unexpectedly which are not always affordable such as doctor visits, dentist visits, hospitalizations, and medicine. Medical aid in this light will provide you with cover for these medical expenses in order to maintain your health status.

So what is the difference between Medical Aid and Medical Insurance?

With medical aid, in exchange for a set monthly premium, you get access to a set of standard medical aid benefits which will cover you up to a certain amount for doctor and dentist consultants, medicine, and hospitalization. When needing medical assistance, the medical bill will be settled directly with the medical service provider.

With medical insurance, you pay a health insurance provider directly to receive cover for day-to-day expenses in the case of a medical emergency that may require you to be in a hospital, that you would not have the funds for if the event should arise.

With medical insurance, the claim will be settled directly with the health insurance member who will be responsible for paying the health care provider. In this regard, if you have medical insurance, you would still need to pay for day-to-day medical expenses such as doctor visits and medicine out of your own pocket.

How do I get Medical Insurance or Medical Aid in South Africa?

To get medical insurance or medical aid in South Africa, you can call or email the medical insurance provider of choice. From here you will need to provide the relevant and necessary information directly related to yourself as well as any other members that you are looking to sign up for medical aid or medical insurance in South Africa.

Does Medical Insurance cover critical illness?

Medical insurance offers cover in hospitals that may not cover some treatments associated with critical illness whereas critical illness cover will pay out a lump sum to pay for medical expenses related to the treatments associated with the critical illness.

Does Medical Aid cover critical illness?

Medical aid provides a portion of critical illness cover while you are in the hospital, but may not cover out-of-hospital expenses and chronic medication and typically medical aids related to the critical illness incurred.

Who regulates Medical Insurance companies in South Africa?

Health insurance companies in South Africa are governed by short-term or long-term law in comparison to being governed by medical aid regulations.

 Who regulates Medical Aid companies in South Africa?

Medical aid companies in South Africa are regulated by the Council for Medical Schemes.

How do I decide between Medical Insurance or Medical Aid in South Africa?

When choosing between medical insurance and medical aid, you need to take note of your budget and what you want to be insured for. If you want to cover yourself and your family for day-to-day medical expenses, then medical aid would be more suited than medical insurance, which is primarily taken out to cover you and you daily in the event of a serious illness or injury that would require hospitalization or costly medical expenses.