Is health insurance more affordable than medical aid?
Health insurance and medical aid seem quite similar, but there are distinct differences which set them apart. These differences are also responsible for the disparity of the price points at which they are being offered to customers.
Even the cheapest medical aid is usually a bit pricier than a medical aid insurance premium.
So, why is medical insurance cheaper than medical aid?
Medical aid, which is regulated by the Medical Schemes Act, is essentially Cover based on tariff codes and procedures. It often has a shortfall due to the difference between the National Recommended Price List and the South African Medical Association rates which is what healthcare professionals charge. Affinity Health wrote in January that Medical Aid must, by law, cover Prescribed Minimum Benefits.
Medical Aid has specified yearly limits for procedures and health events do not need to be specifically stated; it also does not include any personal accident disability and loss of limbs cover.
Medical Aid is also not authorised to include death and/or funeral cover as part of the Medical Aid Scheme. It pays in-hospital benefits according to the National Recommended Price List limiting benefits as per the plan.
This is why medical aid premiums usually start at around R750 per person per month.
How much are medical insurance premiums?
Medical insurance focuses more on accidental injuries, paralysis or illnesses that may occur after you have taken out the insurance.
Medical Insurance is regulated by the long-term Insurance Act.
It may be used as a gap cover in conjunction with your medical aid for cover where your medical aid scheme may fall short. It also protects your financial assets and promotes wellness and health.
You are covered for a certain amount, and everything else will be at your own expense.
Payments for medical insurance start from as little as R150 per month per person.