Avoid a situation when you cannot afford medical expenses
Medical insurance in South Africa is seen as a more affordable alternative to medical aid and is important to cover costs for medical procedures that come at a higher cost which some medical plans will not cover.
How does Health insurance work?
It will pay out a set amount for each day spent in the hospital, no matter what type of treatment is taking place, and can be seen as a top-up when your medical aid funds run out.
The lump sum is paid to you directly to use for payment towards medical treatments as well as expenses encountered while in hospital. These expenses can be seen as the daily cost of the hospital room, doctor fees, the cost of medicine, diagnostic tests, and more directly related to the medical event.
How do I buy Medical Insurance in South Africa?
More and more of the comparative insurance sites in South Africa are adding medical aids and health insurance companies to their websites. As the average South African’s need for good health care, as well as budget-friendly premiums, increases so does the availability of this type of insurance. Because it is more cost-effective than a medical aid it has become more widely available to purchase.
The majority of providers within South Africa will have the option available to get an online insurance quote which will require you to provide necessary documentation along with information regarding your age, pre-existing conditions, and income.
What is the difference between Medical aid and Medical insurance?
With medical aid, in exchange for a monthly premium, you get access to a set of standard medical aid benefits. With 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. With medical aid, the bill will be settled directly with the medical service provider. With health insurance, the claim will be settled directly with the insured member who will be responsible for paying the health care provider.
Does Health insurance cover Critical illness?
It offers cover in hospitals as set out in the policy but 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.
Critical illness cover will also pay for costs associated with living with the critical illness that may affect your ability to earn an income. These could include oxygen at home or a ramp for a wheelchair, for example.
Who regulates insurance companies in South Africa?
Insurance companies in South Africa are governed by short-term or long-term law in comparison to being governed by medical aid regulations. This allows for payment directly to the insured who can then pay the service provider the required amount.
What if I don't take out insurance in South Africa?
Without insurance in South Africa, you could be stuck in a situation where you cannot afford the expense of covering medical costs related to unexpected illness or injury.
Insurance in this regard is highly encouraged for all South African citizens to not become stuck in a situation where they cannot receive adequate medical care, or be able to financially cover the costs related to their health.
It is vital to consider insurance if you have a young family as children are prone to not only illness but also accidents such as broken bones which may require surgery and long and costly hospital stays.
How much should you pay for insurance?
Monthly premiums will depend directly on the insurance company that you are focusing on, as well as factors such as age, medical history, and current health status. You should also consider the different benefits and payouts that different plans may offer. It is important to know what will be paid out in case of a hospital stay or day-to-day expenses such as doctor’s visits or medications if anything.
Best place to source a quote
To get an insurance quote in South Africa, you can call or email the 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 health insurance in South Africa.
Alternatively, many providers in South Africa have the option to complete an instant quote on their website.
Many comparative insurance sites will offer different companies who offer insurance or you can see below which companies can offer you a quote.
How do I claim?
Claims can be processed once you have been discharged from the hospital with a completed claim form which will include all the necessary accounts and membership details.
From here, the claim will be processed and the insurance provider will pay you directly, where you will be responsible to pay the health care provider directly.
A medical emergency can be defined as the unexpected downfall of a health condition that requires immediate medical or surgical treatment. In this case, if medical assistance is not received, it would result in serious harm to bodily functions or serious dysfunction of a bodily organ or part, or put the person’s life at risk.
How do I find the best insurance?
To find the best provider for you personally, you need to assess what your direct medical needs currently consist of. You also need to assess what it is that you want to get out of your insurance plan, should you suffer from an injury or illness.
Do I qualify for insurance in South Africa?
If you are a South African resident or permanent citizen you will qualify for a medical plan.
Is it mandatory to have an insurance plan?
Medical insurance is not mandatory in South Africa, but it is highly encouraged to cover medical costs that will ensure you get the proper medical treatment needed in the case of a medical emergency.