How much does a basic health insurance plan cost me and what am I covered for?


Jade Poole from I Write Words


If you have ever wondered what health insurance is, what it covers and what your plan options are, then keep reading…

The affordable alternative to medical aid, health insurance is something not many people know about or know how it works. This article explains what you need to know about taking out a basic hospital plan, what you are covered for and what it all means…

But first, what is health insurance?

You need to understand that health insurance is not the same thing as medical aid..

Medical aid is something so many of us struggle to afford and it is often just not something the average person can work into their budget.

Health insurance is a cost-effective alternative to this…

Medical insurance (or health insurance) pays out cash to you to cover costs incurred by an event, whereas medical aid provides cover based on pricing codes and procedures and it does not have yearly limits for use.

Medical aid has to cover a certain amount and this amount is often based on the hospital or treatment needed, which is why medical aid costs more.

Health insurance lets you know exactly how much cover you get when you claim and what you can claim for, just like how household or car insurance works.

What is a health insurance premium?

This is the amount you pay every month to have your health insured and is based on your chosen health plan.

Is health insurance the same as a hospital plan?

Some health insurers offer health plans that only cover you for in-hospital costs. So this means you are only covered for accidents and emergencies.

Other health insurers offer routine care too, this means you are covered for dentist, doctor and even eye doctor visits!

It’s all about doing your research to see which insurer gives you the best benefits for your premium.

How much does a basic health insurance plan cost?

It’s a good idea to do some research on what health insurers there are out there and which one has a plan that best suits your needs.

If you have a look at Oneplan Health Insurance (one of my personal favourites), their most basic Core Plan is structured like this…

What is included in a basic health insurance plan?

For R365 a month you are covered for the following:

Health cover:

●     Visits to your doctor, treatments, tests and procedures in rooms based on your cover limits


●     Prescribed medication

●     Baby and child immunisations

●     Flu vaccinations

●     Chronic (ongoing) medication (including ARVs) (if the conditions were diagnosed after the waiting

●     period)

●     Doctors who give you the medication themselves


●     X-rays, sonars, ultrasounds, mammograms, bone density, barium meal or enema

●     CT and MRI scans, other imaging tests and scans

Blood tests:

●     Tests to examine blood, tissue, bodily fluids, smears, swabs and biopsy samples etc. (Tests done over a period of 6 days will be seen as 1 claim)

Dentist visits:

●     Fillings, extractions, fluoride treatment, root canal, dentures (false teeth), crowns, bridges

●     X-rays done in the dentist’s rooms

Eye doctor visits:

●     Glasses (frames and lenses), contact lenses, tinting of lenses

●     This cover works in a 24 month cycle where you can only claim every 24 months according to your cover limit, after the initial waiting period of 12 months.

They also have amazing hospital cover that covers you for:

●     Casualty illness (emergency treatment in hospital but you don’t have to stay overnight)

●     Casualty accident

●     Illness

●     Accident

●     Dread disease

●     Disability

●     Maternity

With any of their health insurance plans you will also have access to 24-hour medical assistance with an emergency dedicated line.

Are there any benefits that stand out from the rest?

The great thing about Oneplan is that they pay you before you see the doctor and also let you go to any doctor you choose, which is the only health insurer I know that does that.

But, like I said, do your research and find an insurer that suits you best. As long as you just make sure your health is covered. 

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