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What is Health Insurance and why is it important?

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The ways of the world may have changed, but having good health is still one of the biggest challenges you can face. That’s why health insurance is becoming a major player in South Africa: It’s giving millions of people the power to protect their wellbeing and their wallets.

Let’s delve into the world of health insurance and see why it could be one of your most important investments yet.


What is Health Insurance?

Usually known as Medical Insurance, policyholders pay a monthly premium in exchange for access to private healthcare.

When you compare it to your car or home, Health Insurance plans work a bit differently: The laws that govern providers are stricter, because their services are seen as a necessity. It’s this security that protects your health, because your premium guarantees access to the medical services you need.

Does that mean this is just cheap Medical Aid? Well, not quite…


Why is Health Insurance cheaper than Medical aid?

A traditional medical aid has to offer Prescribed Minimum Benefits (PMBs), including treatment for 271 different medical concerns and medication for 26 chronic conditions. It must be ready to offer all these benefits to each of its members at any minute, which is why medical aids charge their members such high premiums. Health Insurance plans are more flexible, because they do not have to cover the PMB’s.

The result: Plans that are more affordable, because they only cover the medical services you need.


Why is Health Insurance so important?

These days, our budgets are tighter than ever. So tight in fact, that most people would rather avoid healthcare altogether.

Medical bills waste no time in pilling up, starting with a doctor’s appointment that can cost hundreds of Rands. When you add the cost of medicine and specialised treatments, getting the help you need feels impossible.

Different types of Health Insurance are transforming this reality, because some providers charge less than R500pm for benefits like this:

  1. In-person doctor visits
  2. Chronic and Over-the-counter medication
  3. Dentist and Optometrist visits
  4. X-rays, blood tests and more

In a perfect world, you don’t need these benefits because you are healthy and happy. But when the time comes, wouldn’t it be better to go to private healthcare providers that are dedicated to quality treatment?
That’s exactly what you get with Health Insurance.


Are there other types of healthcare plans?

There are two ways to get private healthcare in South Africa: By having a medical cover plan or paying out-of-pocket. One option is painfully expensive, while the other options usually depend on what fits your budget:


Medical Aid – A plan that covers a wide range of medical expenses according to the National Recommended Price List and Prescribed Minimum Benefits (PMBs)

Hospital Plan – Usually included in Medical Aid plans it covers in-hospital expenses whilst admitted to hospital like theatre, X-rays, blood tests, doctor’s account and other accounts related to your hospital stay

Accident Cover – Seen as one of the cheapest types of plans, Accident Cover gives you access to private healthcare in case of a medical emergency caused by accidents. Benefits include ambulance services, emergency department visits and accidental hospitalisation.

To get what providers call “comprehensive coverage”, you often have the chance to combine these plans. With Health Insurance for example, you can combine it with Accident Cover to make sure you’re protected against unexpected medical emergencies. With Medical Aid schemes, benefits found in a standard Hospital Plan are also usually included.


Is Health Insurance the best choice for me?

Remember, affordability doesn’t mean you are sacrificing quality. The private hospital networks you have access to are filled with healthcare providers dedicated to keeping you healthy. Even though benefits have limits, you can rest easy knowing that your daily medical needs will be covered.

Knowing that you did it without breaking the bank is an even better feeling.


“Get well soon” won’t make you feel better. But Health Insurance will.

Even though we focused on Health Insurance, here’s the truth: You need a healthcare plan. Life is too unpredictable, and your health is too important. Explore the different plans and make an informed decision, so that you can protect your health and happiness.

This is what Health Insurance is trying to help you achieve. When you have your daily medical needs covered, you can focus on life’s other big challenges. Private healthcare is now more affordable than ever before, so it’s time to get the rest you deserve.

Not all Health Insurance 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

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