What is the Difference between Medical Aid and Medical Insurance?



In South Africa, it’s common to hear people talking about medical aid and medical insurance, but many consumers don’t know the difference and, therefore, do not know which option is best for them. The consequences of these uninformed choices affect citizens every day. Indeed, most South Africans know what it’s like to rather skip the doctor because their funds have run out, or be involved in an accident and be taken to a less-than-adequate hospital or clinic because their medical cover doesn’t, well, cover them.
In a bid to better educate South Africans, we thought we’d give you the low-down on the difference between a medical aid and medical insurance, and you can decide for yourself which is better for you. 
Medical Insurance
Traditionally, medical insurance is geared towards providing patients with a lump sum each day that they’re in hospital in the event of an accident or an emergency. It is often seen as a bridge between hospital fees and medical aid funds. It is best to think of it as a short-term insurance product for your health – in South Africa, medical insurance is regulated by the Short-term Insurance Act. As it is not regulated by the Medical Schemes Act like medical aid is, health insurance can, legally, offer cover for situations that medical aid can’t. For example, medical aids cannot provide personal accident disability and loss of limbs cover, as well as death/funeral cover. However, true to our style, we’ve done things a little differently. While many people do use our insurance to cover the shortfall of their medical aids, it is actually our out-of-hospital benefits that make Oneplan so attractive. 
Medical Aid As mentioned, these are regulated by the Medical Schemes Act. In contrast to health insurance, they must cover prescribed minimum benefits, and, rather than covering specific events, they have specified yearly limits on events. Furthermore, medical aids pay in-hospital benefits which can fall short due to the discrepancy between the rates of the hospital and the scheme cover. This is one of the primary reasons that people choose to supplement their medical aid with medical insurance. At Oneplan, one of our mottos is to put health care back into the hands of the people, and we carry this maxim in everything we do. Our health insurance is simply more affordable for South Africans, and they get to choose what they need, when they need it.
medical insurance We’ve turned health cover on its head. Instead of patients paying the doctor and then waiting weeks to get their money back, we pay you before you even see the doctor! You can learn more about how our unique Onecard works here. Images credit: Think Stock

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