The Ultimate Guide to Downgrading to a Hospital Plan in South Africa!

Pros:

• Lower Premium: Hospital plans have lower premiums.
• Emergency Benefits: Although they do not cover day-to-day medical expenses, hospital plans do provide benefits for emergencies and some for casualty treatment.
• Prescribed Minimum Benefits (PMBs): Hospital plans give guaranteed cover for 270 life-threatening conditions and 26 chronic conditions that include emergencies, diabetes, and asthma.
• Network hospitals are private hospitals

Cons:

• No Day-to-Day Costs Benefit: However, if you are healthy and have no need for extensive treatements, you should be able to self-fund these expenses.
  If you frequently require doctor visits, medication, or other non-hospital care, a comprehensive plan covering these costs might be more cost-effective in, even with a higher premium.
• Deciding if a hospital plan or comprehensive plan is best to join depends on your individual needs and budget.
  If you can you comfortably manage out-of-hospital expenses yourself, joining a hospital-only plan could offer significant premium savings while providing you with essential hospital benefits.

Fedhealth Medical Aid is truly an exceptional medical aid because they really do offer the best, affordable, unique, value-added benefits of any scheme in South Africa.

The Fedhealth flexiFED plans offer unlimited hospital cover combined with a day-to-day savings fund that you only repay once you spend it!

Your premium remains that of a hospital plan until you spend from your savings.
If you choose NOT to use the savings, your premium remains that of a hospital plan until you do use your savings.

A portion (1/12th) of what you spend is then repaid monthly, interest free over the following year, as an additional amount to your premium.
When it is repaid your premium drops back down to that of a hospital plan.
(Other medical aid plans force you to repay a portion of the savings from the start of your plan, whether you have spent them or not That is money you cannot use as you wish. A forced loan!)

All plans have excellent in-hospital benefits and the offer of day-to-day savings which are re-paid only when you spend them!

Just look at their hospital benefits:

1. No overall annual limit private hospital cover, for emergencies and planned procedures.
2. Unlimited network GP and Specialist covered at cost in-hospital.
3. Treatment for selected procedures in a day ward, day clinic or doctors’ rooms.
4. Unlimited Specialised radiology.
5. Unlimited accident and emergency treatment.
6. Emergency treatment at a trauma unit of a clinic or hospital, like stitches and broken bones – whether you’re admitted to the hospital or not.
7. Costs paid for treatment at a clinic or hospital with a life- threatening condition where you are admitted immediately for further treatment.
8. If medicines are not readily available Fedhealth will arrange for medicine or blood products to be delivered to the facility where you are being treated.
9. Unlimited maternity covered at cost with network GPs and specialists.
10. Specialised radiology, like MRI/ CT scans done in or out-of-hospital, is paid by the scheme and not you!
11. Chronic illness.

Premiums range from as little as R 1,055 pm for a single member.

Now you can have one of the finest hospital plans and the resources to pay high, unforeseen day-to-day costs.
You can cover your healthcare risks in one plan, where you control what it costs you!

Fedhealth also gives you a safety net of funds once savings are spent and your claims have added up to a predetermined amount. So, you always have funds to pay for healthcare needs.

Read more about Fedhealth Medical Aid benefits

The Genesis Hospital plan is a hospital plan that pays essential dental costs as well.

Rated as one of the best hospital plans in South Africa by the GTC Medical Aid Survey: Benefit and cost comparisons.

Genesis offer you:

• full cover for private hospital expenses, including ward and theatre fees, specialists, medication, and more, from admission to discharge.
• hospital and related accounts (e.g. theatre costs, x-rays, pathology, physiotherapy, blood transfusion, medicines, etc.) are covered at 100% of Scheme Tariff, including day clinic or the recovery room charges of an unattached operating theatre
• General practitioners and specialists are reimbursed at cost up to 200% of Scheme Tariff. (plan-dependent)
• Emergency pre-hospital treatment, evacuation and transport.
• the lowest annual contribution increase of all South African medical aids over the last 10 years. Only 4,7% this year!
• one of the lowest child contribution rates!
• the use of any doctor or specialist you choose as there are no compulsory networks!
• psychiatric treatment, so vital during this pandemic.
• out-of-hospital MRI and CT scans as well!
• diagnostic endoscopes
• pain relief for conservative back and/or neck (spinal/vertebral) conditions.
• surgical procedures done in doctors’ rooms
• cancer, stroke, motor-neuron disease, organ transplant and Hospice.
• Chronic illness.
• screening tests.

AND

• Basic dentistry - yes cover for day-to-day and in-hospital dentistry!

Premiums range from as little as R 1,610 pm for a single member!

Genesis does not “authorise” treatment for any admission to hospital. Instead, you are issued with a hospital admission reference number because, nor do they it interfere with any clinical decisions or protocols made by or recommended by your doctor(s).

This medical aid is really a hidden gem!

They are the smart choice when it comes to affordable, hospital only cover!