Getting medical insurance /health insurance can be confusing considering the steps, costs and paperwork required before getting covered.
In this article, we explore Accident Cover for medical emergencies.
What is considered a medical emergency in South Africa?
A medical emergency is a sudden and life-threatening health condition that needs immediate medical treatment. If this treatment is not provided, it could seriously harm the body’s functions or organs and put the person’s life at risk. An accident or a serious illness (heart attack or stroke) is an emergency.
We can all identify with having a “life flashing before your eyes” experience somewhere in our lives. It is during these times when we may question how prepared we are for such an event.
Medical procedures normally covered in medical emergencies
The moment you are involved in an accident or get seriously ill (stroke or heart attack), it is essential to receive the best healthcare. This is why, Accident Cover for medical emergencies provides cover for emergency department visits, ambulance and stabilization and In-hospital treatment.
These benefits only apply to accidental injury, heart attacks and strokes and do not include any other illnesses. Some insurance providers have buy-up options for additional illness emergencies. Depending on what you choose, some of these benefits may not apply.
How does cover for medical emergencies related to accidents, strokes, and heart attacks differ from regular day-to-day cover?
Day-to-day cover takes care of our daily medical needs while Accident Cover, also known as emergency medical insurance takes care of emergency medical needs relating to accidents, heart attacks, and strokes.
Day-to-day cover includes access to:
Medical emergencies related to accidents, strokes, and heart attacks include the following benefits:
• Ambulance and stabilisation
• Emergency department visits
• Hospitalisation in the case of emergencies
• Hospitalisation for heart attack, and strokes.
Are there any exclusions or limitations to the cover for medical emergencies related to accidents, strokes, and heart attacks?
Depending on the insurance provider, claims will not be paid or considered for an incident, illness, accidental harm or events directly or indirectly caused by the following:
• Suicide, attempted suicide, wilful injury to oneself
• Drug use (illegal or legal) unless this was prescribed and taken in accordance with the instructions given by a health care provider
• Any defence force, police force, medical rescue services, firefighting services, correctional services facility or the disarming of explosives
• Civil commotion, labour disturbances, riot, strikes, lock-out, and other incidents in relation to this
These are just some of the exclusions or limitations that some insurance companies look into before paying out clams.
We can never be ready for situations like accidents, illnesses (strokes and heart attacks), but we can take comfort in knowing that we are prepared and covered for our way back to recovery. We hope this article served its purpose in educating and helping you make an informed decision when it comes to planning for the future.
Not all Accident Cover plans are the same and benefits as well as limitations may vary. Descriptions of benefits given are meant to be for general educational purposes only and you must ensure that you seek the advice of a broker to ensure any product choice you make suits your individual needs