Low cost healthcare options if you can’t afford medical aid

With monthly contributions of over R1 000 a month, even the cheapest medical aid is beyond the reach of many South Africans. The good news is that there are health insurance policies, which are cheaper than medical aid and will give you some cover for your healthcare costs. We take a look at the cheaper ways to pay for medical expenses.

Primary health care policies

The cheapest health insurance policies are primary healthcare policies, which cover primary care like GP and dentist visits. There are different kinds of primary healthcare policies, each offering different benefits. Some only cover GP visits, while others also cover medication and chronic medication, but you will pay more for these.

Some of these policies also give you the option to add benefits such as funeral cover and critical illness, although this does cost more.

These policies should not be confused with medical aid, which offers cover for prescribed minimum benefits as well as day to day care and hospital costs.

Do primary healthcare policies cover all healthcare providers?
Most of the policies we looked at only cover full costs at healthcare providers within their network. If you use another healthcare provider, you may have to pay all or some of the cost.

Where can you get these policies?
These should be sold by authorised financial services providers as they are classified as short-term insurance. Providers include Oneplan, Affinity Health, Elixi, Ubuntumed and others.

How much do they cost?
We looked at 7 different companies and found plans priced from R250 a month for an adult member, and a family plan for R817 a month. There are many different plans with different prices – the more cover you choose the higher the price. The average starting price is around R350 a month for an adult for basic day to day care, at certain providers and with limits.

These policies can charge different premiums depending on age. For those over 55, premiums may be a lot higher.

Is a primary healthcare insurance policy suitable for me?
Most of these policies pay for primary healthcare such as GP visits, which can be expensive over the year. If you find you are spending a lot on day to day healthcare expenses, it’s worth looking at these policies. However, if you have high hospital bills, they won’t cover this.

Hospital cash back policies

Hospital cash back policies pay a certain amount if you are in hospital – either a lump sum or an amount per day you are in hospital such as R500 a day. They pay this directly to you, and you can choose what to do with the money. They do not cover any day-to-day expenses and in most cases, you have to have a minimum stay in hospital of 3 or more days.

The maximum a hospital cash back policy can pay per year is R20 000. This doesn’t go far in terms of private hospital costs but would be useful in helping with post-operative medicine, care and living expenses during recovery.

Hospital cash back policies can also offer additional benefits such as cover for accidents and dread disease such as cancer, which can increase the amount of cover you have. They are available from insurers like Metropolitan and financial services providers like FNB.

If you have both a primary healthcare policy and a hospital cash back policy you can have cover for day to day medical expenses and hospital expenses, but only up to certain limits.

Savings account

A final option to fund medical expenses is to set up a savings account and put money away each month. This may not be enough to cover all your expenses but should pay for medication and visits to a healthcare provider if you are a disciplined saver and don’t use the savings for another purpose.

An affordable option

Primary healthcare policies and hospital cash back policies offer an affordable option to pay for some of your medical costs. They won’t pay for all your medical bills, but they will cover key day to day benefits for you and your family, and some cover for hospital expenses. Be sure to find out exactly what the plan covers before you buy, as there are many different options.

Questions to ask when buying medical insurance

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