Medical Insurance
We discuss the difference between Medical Aid and Medical Insurance. The difference between Medical insurance and Medical Aid is that Medical Insurance policies cover a set of predetermined benefits, each of which has a monetary value associated with it. Medical Aid plans, on the other hand, charge members a monthly premium to provide a predetermined package of standard medical benefits.
Get Medical Insurance outlines the difference between Medical Aid and Medical Insurance.
In South Africa, accessing private healthcare can be prohibitively expensive for most people. Even minor healthcare incidents can send you digging into your savings or putting your credit card on the line. It’s important to understand the differences between Medical Aid and Medical Insurance. These two terms are often used interchangeably. They are, however, not the same thing. There are significant differences between Medical Aid and Medical Insurance.
Medical Aid Schemes in South Africa provide financial cover against the cost of medical care in exchange for a monthly premium. Depending on your Medical Aid Scheme, you may be able to claim for in-hospital care, day-to-day expenses such as visits to the general practitioner, dental treatment, or medication.
Medical Aid Schemes in South Africa are governed by Medical Schemes Act 131 of 1998, and are regulated by the Council of Medical Schemes. The Medical Schemes Act governs and oversees all Medical Aid Schemes in South Africa. Medical Aids are required to give certain Prescribed Minimum Benefits (PMBs) for a wide variety of conditions. These benefits include a variety of treatments for chronic conditions and a detailed list of in-hospital procedures. Anyone who is a member of a Medical Aid, no matter what plan they’re on, can receive treatment for 270 hospital-based and 25 chronic conditions, and the price of these will be covered in full.
Medical Insurance, also known as Health Insurance, is an affordable and cost-effective form of coverage for South Africans. Medical Insurance has given South Africans in the lower-income bracket access to private healthcare facilities and services.
Medical Insurance is governed by the Short-term Insurance Act and does not have Prescribed Minimum Benefits (PMBs). Medical Insurance provides certain types of medical cover and day-to-day benefits and cover for some chronic conditions. Medical Insurance focuses more on things like General Practitioner (GP) visits, virtual doctor consultations, pharmacy based nurse visits, basic dentistry, optometry, chronic medication and more.
Medical Aid provides a more comprehensive coverage when compared to Medical Insurance. Unlike Medical Aid, Medical Insurance does not have a PMB list. Medical Insurance generally provides cover for basic healthcare expenses, including General Practitioner (GP) visits and dentistry and in some cases, hospitalisation due to an emergency. Medical Aid on the other hand, covers a much wider list of conditions and in-hospital procedures.
Medical Aid premiums are usually risk-rated. This means that an insurer may require someone who hasn’t been on a Medical Aid Scheme for a period of time, or someone who is beyond a specific age to pay a higher premium. With Medical Insurance, however, all members on the same plan will pay the same price, unless the plan selected is a family plan.
The vast majority of people will, at some point in their life, need medical attention. Medical Insurance coverage can give you and your family the medical care you need. Get Medical Insurance today.