Medical insurance is a type of insurance that pays for all or parts of
a person’s private healthcare. In South Africa medical insurance is commonly referred
to as ‘
medical aid’. The term ‘medical insurance’
is also used interchangeably with the term ‘health insurance’ and typically mean
the same thing, although their definitions may vary on insurance policy documents.
The reason why people buy medical insurance is to cover the costs of healthcare.
This can include GP visits, hospitalization, surgery, tests etc.
Medical insurance can take various forms like individual plans, group plans, government
health plans and workers’ compensation.
Individual Plans
These types of plans are generally sold directly to the general public. These types
of plans are mostly the traditional type of plan where the medical insurance company
reimburses the healthcare provider for services rendered.
Group Plans
Some employers offer medical cover for their employees and their dependents via
group health plans. The employer usually covers all or part of the cost. Group plans
are also found within organizations like student groups, religious organizations
and professional associations.
Managed Care
This form of medical insurance is becoming more popular. The insurance company manages
the inured person’s healthcare by approving certain procedures and assigning affiliated
doctors and hospitals to the insured person.