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Hospital Plan vs. Comprehensive Cover – The Basics

The Differences Between Comprehensive Medical Aid and Hospital Plans

When you are in search of the best health insurance cover for yourself or your family, you eventually come to the decision of whether to invest in a hospital plan or a comprehensive medical aid. Comprehensive medical aids are plans that offer all the benefits of hospital cover, but in addition, feature a day-to-day benefit, from which you are covered for your consultations fees and cost of medication, among other things. A hospital plan is exactly what it sounds like – a plan that covers the costs of in-hospital treatment in the event of the insured being hospitalized.

So basically, the key difference is that a hospital plan covers in-hospital costs and a comprehensive medical aid covers both in and out-of-hospital costs. Your specific healthcare needs will help you determine the best option for you or your family members.


Comprehensive medical care is comparatively expensive, but of course, the benefits ARE MAJOR. With comprehensive healthcare, you have a peace of mind that practically all of your medical costs are covered by your insurance. Of course, comprehensive plans do vary and it will be necessary to become familiar with the particulars of your specific provider as all vary in what they do and do not cover, and also the extent to which they cover.

Hospital plans are a sort of entry-level medical aid plan, and in the event that you are hospitalized, you won’t necessarily have to dip into your emergency savings (we do hope you have one of those…). In-hospital procedures can run high bills as they are usually labor-intensive and involve specialized knowledge and specialist professionals. There are also specialized hospital plans that come with an added benefit of an MSA, which is a medical savings account, which is a savings account with funds attached to your plan that you can cover shortfalls with. These are naturally more expensive than regular hospital plans but can be useful for people who are not diligent in saving money for medical emergencies.


As mentioned briefly, different healthcare providers do offer different types of cover. Each provider will have a set of plans to choose from and each plan will cover a selected set of surgical procedures. In the case of hospital plans, it may even be such that the only procedures covered by the plan are those that require an overnight stay at the hospital, which will mean that any in-hospital treatment that is conducted during a day is at your own cost.

Further, both hospital plans and comprehensive plan each will have a specific rate at which medical expenses are covered. Healthcare professionals may charge at a higher rate than what your healthcare plan covers, which means you will be required to pay the difference. For example, your plan covers 200% of the cost, and your specialist charges a rate of 300%. This leaves the remaining 100% payable by you. These are the drawbacks you can expect to encounter from each of these types of plans.

Choosing Between a Hospital Plan and Comprehensive Cover

Generally speaking, a healthy individual who dies not expect to incur regular expense son over-the-counter medication or to consult with a GP regularly can usually get away with a basic hospital plan to cover emergency cases like a car accident or invasive surgery. However, with increasing age, it becomes more necessary to have the added financial support system offered by comprehensive plans. Periodically reassessing your healthcare needs will ensure that you do not find that you are under-insured by your healthcare provider, and you can increase or alter your cover accordingly as your needs evolve over time.

If you are uncertain about how to go about assessing the best option for you, it may be best to consult with a medical aid consultation, who will offer you the best options to choose from based on your current age, health, and risks. Becoming acquainted with the applicable upgrade costs to other covers, excess payments, late-joining fees, and other related information will help you to make a more informed decision. So it is important to read up as much as possible on your options before making a solid decision on your healthcare.


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