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SA's No 1 Insurance Blog

In my last blog post I really pushed home the need to take out a medical aid top-up product. The extra in-hospital coverage is essential nowadays and the good news is that the premiums are cheap as chips.  Medical aid top-up or gap-cover products cover you for a few different types of risks (depending which product you take out).  I’ve spoken about the Pro-Care product offered by Turnberry Insurance group which boosts your in-hospital tariff coverage to 400% regardless of which medical aid you belong to. In this blog post I am going to tackle another great product called Maxi-Care offered by the same guys at Turnberry.

This top-up product is a must for those of you that have a capped in-hospital benefit on your medical aid plan.

Hold on a second, Brendan. What do you mean by a capped in-hospital benefit? Aren’t all my in-hospital expenses covered by my medical aid? Good question. Let me answer that for you.

The first thing you need to understand is that your medical aid plan has two separate benefits aimed at covering two different types of medical costs. The first benefit covers your smaller day-to-day medical expenses like GP visits, flu medication, annual check- up with your Gynae etc. The 2nd benefit covers your in-hospital expenses and these are generally the very heavy costs associated with private healthcare. While most of us can fund our day-to-day medical expenses, very few of us have enough cash to carry hospital related expenses. That’s why we belong to medical aid schemes.

This is the problem though!

Some medical aid plans on certain schemes in South Africa don’t have an unlimited in-hospital benefit. That means that there is a ceiling or rand cap on the amount of cover you enjoy while you are in hospital. Now this can be highly problematic if you have an extended stay in a private hospital.

Imagine for a second that you are on a medical aid plan that has a R500 000 cap on your in-hospital benefit . You are involved in a car accident and land up in the Intensive Care Unit for 90 days. Is the R500 000 in-hospital benefit going to be sufficient? Let’s be honest, probably not. That means once you are through the in-hospital benefit limit, the balance of the hospital account is going to be for your own pocket.

So what can you do about it?

Well if you have a medical aid plan with an unlimited hospital benefit, you have no worries. If your in-hospital benefit is capped then you need to take out a medical aid top up product to boost your coverage.

The Maxi-Care product by Turnberry Insurance Group offers you an increase on your overall annual hospitalization limit. The great news is that it fits onto any medical aid plan in the country. The Maxi-Care standard policy for R100 per month increases your hospital benefit by R1.75 million (per family) annually. The extended policy for R122 per month increases your cover by R3.5 million.

Example:

John belongs to a medical aid plan that has an in-hospital limit of R500 000. He is concerned that this might not be sufficient cover if he has a pro-longed stay in hospital. John takes out the Maxi-Care standard product offered by Turnberry Insurance Group and boosts his in-hospital coverage by another R1.75 million. Simply put, John now enjoys a total of R2 250 000 hospital cover.

If you are unsure whether your medical aid in-hospital benefit is capped, do yourself a favour and check with your medical aid scheme. If it is capped, don’t take a chance – grab some extra coverage with a medical aid top-up product.

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