The incredible benefits of Health Insurance and why it’s so essential for you and your family to be able to access private sector healthcare.
Let’s paint a picture. Your chest hasn’t been doing too well for a few weeks now. There’s a cough that simply won’t leave. You know you should go and see your doctor but the thought of paying for a private consult is enough to put you off. You’re nervous that they’ll recommend you to a specialist, which you can’t afford or even more seriously, that you’ll need to be admitted into the hospital. Which you definitely can’t afford. Plus, you’ve been to the clinic before, and you didn’t feel that the clinician had the time or the resources to give you the care you needed.
When we hear of people in situations like this, it makes us feel awful. Why should you have to miss out on proper medical care because of your budget?
Unfortunately, this is the case for thousands of South Africans across the country. So, what’s the solution?
Private sector healthcare in South Africa
South Africa is fortunate enough to have hospitals of exceptional quality across the country. The unfortunate part is that the majority of these hospitals are private, which means they are run independently from the government.
Clinics and local government hospitals have been known for failing to provide adequate healthcare. This has less to do with the quality of the doctors and nurses and more to do with overcrowding, lack of funding and poor infrastructure.
In an ideal situation, government hospitals would be safe, well-run and trusted. Today, and for the foreseeable future, that just isn’t the case.
Why do people favour private sector hospitals?
Citizens will place top priority on being able to access private hospitals for the following reasons:
- Advanced resources and technology
- Clean rooms and highly trained nursing staff
- Access to a variety of doctors and specialists
- Excellent care and service
- No long lines and immediate emergency care
But let’s stop right there. Because whilst many people favour private sector healthcare, there’s a massive block in the road: the cost. Private hospitals expect a sizable deposit before they will treat you, even if you’re in an emergency. This is why private hospitals will only accept patients who have a health insurance policy, which brings us to our next point.
How can I access private sector healthcare?
Health insurance is the only way you can guarantee access to a private hospital in South Africa. Something we should clarify is that private sector healthcare isn’t just limited to hospitals, and neither is health insurance.
Many people prefer to go to doctors who run under a private practice for personal relationships and ease of access.
Health insurance covers you for the cost of private healthcare, meaning you can claim back for any private doctor’s visits or emergency hospital services, depending on your specific plan.
Read this: 5 Things You Need to Know Before You Compare Health Insurance Plans
Let’s look at one of our plans, for example.
The Blue Plan (currently) would cost you from R1000pm. In this plan we include:
Hospital benefits
Casualty illness and accidents
This refers to emergency treatments for illnesses or accidents where you visit the emergency department of a hospital, but you don’t need to stay overnight. You’ll be covered for up to R5 800 for life-threatening emergencies in casualty units.
Related: What Does Emergency Casualty Cover Entail?
Accident cover
Blue Plan members are covered for up to R245 000 per insured event and up to R490 000 per family per event.
Family death cover
You want health insurance that thinks of the bigger picture. Under the Blue Plan, we cover the main member for R15 000, your partner for R15 000, children between 14 and 21 for R15 000, children between 6 and 13 for R10 000, and children between 1 and 5 for R7 500.
Ambulance and Emergency Services
24-hour Medical Assistance with an emergency line dedicated to helping you out. If you’re in a life-threatening situation, the insured member will be transported by ambulance to the nearest appropriate medical facility. And did we mention that we cover any private hospital? That means you don’t need to fret about where to go when something goes wrong.
Day-to-day benefits
It’s not always about the big stuff – the small stuff adds up, too. Here is what our Blue Plan covers in terms of routine care benefits:
- Doctor visits – You will be covered for up to R420 per visit to your doctor.
- Scripted medication – Up to R190 per script.
- Blood tests – We cover up to R505 per event.
- X-rays – We cover up to R505 per event.
- Dentist visits – We cover up to R685 per visit with a maximum of 3 visits a year.
- Pregnancy – We cover maternity care for up to R660 per visit and allow for 3 visits per pregnancy.
- Optometrist – Up to R1215 – Limited to claim this every 24 months per dependant.
Read this next: 7 Signs That You Need to Go See a Doctor
PSA: All of these prices are subject to the time this blog was written. For updated costs, please follow this link!
So you see, having health insurance can go a long way in helping you afford private sector healthcare, both in and out of hospital.
Yours in affordable health insurance,
Oneplan
