The difference between the two can very simply be explained as the following:
1. A
medical aid has certain benefits which it offers, such as dentistry, hospital, day to day medical expenses, glasses and prescribed minimum benefits such as chronic medication etc. The plan works that you pay a premium and if you need medical cover, the medical aid will see if you are covered in terms of that incident and then pay to the doctor or hospital etc. The amount payable can vary, and the provider’s bill is settled directly. It is important to note the following in respect of medical aids; Every year, medical aids change their benefits unilaterally, they increase premiums, and offer clients a choice of schemes with varying benefits. A client would select the level of cover he/she can afford and need, and then continue for the rest of the year. Benefit and cover is calculated based on how many people are on that particular medical aid and how much doctors etc. increase their fees. It is an annual review.
2. OnePlan is a
medical insurance. This insurance works on the same basis as car and household insurance. The insurance cover works similarly to that of a medical aid, but the difference is that you are covered for insured events (eg. You get ill and need to go to hospital). In the same way that short term insurance would pay out a certain amount if your car got stolen, so too will this insurance pay out if certain risk events happen. If your bills are more than your insured amount, you will be liable for the balance yourself. In fact, you remain liable for all bills, and basically use your insurance payout to cover these costs.
With OnePlan offering medical insurance, the company does not underwrite the plan themselves but uses the products of various insurance companies, and markets these to people like you. They are therefore bound by the terms and conditions of the insurance cover, and don’t make these rules themselves.