A hospital plan covers you for any medical procedures that are performed in a private hospital, such as if you’re in an accident and need an emergency operation. If you need cover for medical attention given outside of a hospital, like seeing your GP, visiting the dentist or getting new glasses at the optometrist, a hospital plan would not cover these costs – however a comprehensive medical aid plan would.

Because of this distinction, hospital plans are much cheaper than full medical aid plans, because you get less coverage. Here’s more on these two medical aid options:

Hospital plans

A hospital plan requires you to pay a monthly premium that would then cover you for treatments and procedures as an in-patient in a private hospital. Any medication or doctor visits out of hospital would be for your own account. If you need to go into hospital for a planned procedure, you would need to get authorisation from your hospital plan provider (medical scheme) beforehand, except in an emergency, when your provider would arrange your admission directly with the hospital.

Comprehensive medical aid plans

Many medical aid plans provide both in-hospital and out-of-hospital cover, depending on which option you choose. So you’ll be covered for all the things a hospital plan covers you for, plus day-to-day medical expenses, such as going to the doctor and dentist. Depending on your plan though, your day-to-day savings (called your Medical Savings Account or MSA) are limited up to a certain point. So, make sure you do your research before signing up to a medical aid plan, to ensure the limits will be enough for you and your family.