Being admitted to hospital is never a plan, but it happens anyway. However, it is important to ensure that when it happens you are not caught off guard. If a hospital plan is what you have in mind, this is what you should know according to Elmarie Jensen, marketing manager at Genesis Medical Scheme.

Being admitted to hospital is never a plan, but it happens anyway. However, it is important to ensure that when it happens you are not caught off guard. If a hospital plan is what you have in mind, this is what you should know according to Elmarie Jensen, marketing manager at  Genesis Medical Scheme.

It covers in-hospital procedures only

According to Jensen, a hospital plan does not cover your day-to-day visits to the doctor or prescriptions. The plan only pays out when you have been admitted to hospital for treatments and procedures.

It covers the cost of prescribed chronic medication

According to the Medical Scheme Act, all medical schemes are required to provide cover for prescribed minimum benefits. Hospital plans are required to cover you for 25 prescribed chronic conditions which are listed as one of the benefits.  For example, if you are living with diabetes, the hospital plan must pay for you medication to control the condition.

Your medical scheme can provide a list of hospitals that you can go to

Jensen says your medical scheme may recommend a list of hospitals you may be admitted to. She says that these hospitals are usually the ones your medical scheme company has an agreement with regarding the different rates. In cases like this, your hospital bill may be paid in full because the plan will cover the rates.

Hospital plans are affordable

Jensen says hospital plans are popular with the newly employed and lower-income groups. This is because this health plan offers just enough cover for their lifestyle.

Hospital plans are suitable for young, healthy people

According to Jensen the plan is recommended for people with a healthy medical history.  She says people who take care of their health do not spend a lot of time at the doctor’s office. According to her, they only use a hospital plan in the case of an emergency.

The unlimited cover may not be unlimited at all

Jensen says you must be careful not to get exploited by medical schemes. She says even though some medical schemes offer unlimited cover, they only pay out a certain amount for a certain period.  However, if the individual’s hospital visits are more than usual, the medical scheme may not be able to pay those costs.

Shopping around and reading the fine print can go a long way to help you choose the right hospital plan.

This article has been prepared for information purposes only and it does not constitute legal, financial, or medical advice.The publication, journalist, and companies or individuals providing commentary cannot be held liable in any way.Readers are advised to seek legal, financial, or medical advice where appropriate.