5 Best Hospital Plans for Pensioners and Receivers of SASSA
The 5 Best Hospital Plans for Pensioners and Receivers of SASSA in South Africa revealed.
We tested them side by side and verified their hospital plans.
This is a complete guide to the best hospital plans for pensioners and receivers of SASSA in South Africa.
In this in-depth guide you’ll learn:
- What is a Hospital Plan?
- What is SASSA?
- When do you qualify for SASSA as a pensioner?
- When are you considered a pensioner when joining a hospital plan?
- Which hospital plan has no waiting period for pensioners?
So if you’re ready to go “all in” with the best hospital plans for pensioners and receivers of SASSA in South Africa, this guide is for you.
Let’s dive right in…
Best Hospital Plans for Pensioners and Receivers of SASSA (2023)
|🩺 Medical Aid||✔️ Offers Hospital Plans for SASSA Receivers/Pensioners?||⚕️ Plan Offered||👉 Sign Up|
|1. Discovery Health||Yes||Discovery KeyCare Plan||👉 Apply Now|
|2. Keyhealth Medical||Yes||Silver Option||👉 Apply Now|
|3. Medshield Medical Aid||Yes||MediPlus Prime & Compact||👉 Apply Now|
|4. BestMed||Yes||Network Plans||👉 Apply Now|
|5. FedHealth||Yes||flexiFED Savvy||👉 Apply Now|
5 Best Hospital Plans for Pensioners and Receivers of SASSA
- Discovery Medical Scheme – Overall, Best Hospital Plan for Pensioners and Receivers of SASSA in South Africa
- Keyhealth Medical Scheme – Top Extensive Medical Protection
- Medshield Medical Scheme – Broadest Range of Low-Cost Medical Aid Plans
- BestMed Medical Scheme – Best Pay-As-You-Go Private Healthcare
- Fedhealth Medical Scheme – Best Customer Service Medical Aid
Introduction to Hospital Plans Suitable for Pensioners
Most pensioners can find it difficult to fit in medical aid cover in their limited income. With less than 6% of South Africans able to retire comfortable in financial terms, medical aid premiums can sometimes be impossible to afford for pensioners.
Most medical aid schemes offer cheaper options which entails a basic hospital plan, with some added prescribed minimum benefits, as set by law.
According to research, more than one-third of South Africans depend directly and indirectly on grant payments. Of them many are pensioners who are dependent on SASSA pensions.
What is SASSA?
The South African Social Security Agency, or SASSA, is the South African government body that handles funds and other services related to social security. It also handles and gives out handouts and allowances to groups of people who are at risk of being poor and need help from the government to raise their standard of living.
Sections 24-29 of the South African Constitution’s Bill of Rights identify citizens’ social and economic rights. So, the government takes sensible legal and other steps, within the limits of its resources, to help people gradually realise this right. The SASSA Act of 2004 and its rules make it possible for South Africa to give seven big social grants to groups of people who are most likely to be poor. Among them are: Child support grants, Foster child grant, Care dependency grant, Disability grant, Grant in Aid, Older person’s grant, War veteran’s grants and Social relief of distress grants.
Pensioners who were born in South Africa or to live here permanently, are South African citizens and qualifies for the grant, can get the monthly pay-outs.
Fortunately there are some medical aid schemes with hospital plans that pensioners, also those who receive SASSA grants, can afford. These options are not medical aid for pensioners specifically but plans that cater for lower income earners.
To cater for the growing demand for medical aid cover for older people, schemes have designated plans for people who are living on an income below a certain threshold. These plans usually require services from certain network providers.
You might also like to know more about 5 Best Medical Aids for SASSA Pensioners in South Africa reviewed
Can a SASSA Pensioner Join a Medical Aid’s Hospital Plan?
Medical schemes in South Africa cannot restrict membership by age but cost is the main factor for pensioners who may be living on a lower income during the retirement years.
Any person who starts on medical aid cover for the first time after the age of 35 years is further charged a later joiner penalty that is added to the monthly medical aid contribution. This can significantly increase the monthly premiums and sometimes render medical aid cover unaffordable for a pensioner.
The late joiner penalty is not a standard fee but is calculated according to the current age of the person applying for medical aid membership, and previous years on medical aid cover that can be verified.
This simply means that the older you are, the higher the late joiner penalty. It also means that if you have been on medical aid previously, then this may help to lower the current medical aid premium.
Such a late joiner penalty will not be levied on the medical aid premium if a pensioners are transferring from one medical scheme to another, provided that they were not already liable for a later joiner penalty with previous cover.
Waiting Periods for Seniors
Another major factor that seniors have to bear in mind is that every medical scheme has waiting periods in place. The general waiting period and pre-existing condition waiting period applies to any new member of a medical scheme, even if it is only a hospital plan. However, it may be more of a concern for seniors whose need for medical care cannot be delayed.
The general waiting period for hospital plan benefits are three months of cover during which no hospital bills will be covered by the scheme. Pre-existing condition waiting periods usually apply to twelve months of cover during which claims for the treatment of a pre-existing disease will not be covered by the scheme. Once these waiting periods are finished then members can lodge claims for hospital care.
Even with essential hospital plan cover, pensioners will still have to pay for some costs out of their own pocket. This requires careful planning and saving, especially for SASSA pensioners with a very limited income.
1. Discovery Medical Scheme
Discovery Health Medical Scheme (DHMS) is the largest open medical system in South Africa and anyone may join this scheme.
The Discovery Health Medical Scheme offers more than 20 different health plan options, a few of which are suitable as hospital plans for pensioners.
Affordable Discovery Medical Aid options that are in essence hospital plans, include the following
The Priority Series plans offer cost-effective in-hospital cover, essential chronic medicine cover and day-to-day benefits with a limited Above Threshold Benefit.
Pensioners can choose from the Saver Series, which is economical, provides in-hospital cover, essential chronic medicine cover and day-to-day benefits through a Medical Savings Account. Another value-for-money series of hospital plans that provide unlimited private hospital cover and essential cover for chronic medicine but with no day-to-day cover, is the Core Series.
An even more affordable option for pensioners that still provides basic coverage, is a plan from the Smart Series or Keycare Series.
These plans provide the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover if you use providers in a specified network.
This Saver series is economical, provides in-hospital cover, essential chronic medicine cover and day-to-day benefits through a Medical Savings Account.
The Cover Series is a value-for-money series of hospital plans that provide unlimited private hospital cover and essential cover for chronic medicine. The benefits do not include any day-to-day cover.
The Smart series of plans provide the most cost-effective in-hospital cover, essential chronic medicine cover plus limited day-to-day cover for pensioners if they use providers in a specified network.
2. Keyhealth Medical Scheme
Keyhealth provides a choice of 6 plan options. Preventative care benefits are offered through Health Booster on all options. Easy-ER is free, direct access to hospital’s emergency room for medical treatment in emergency situations.
The Silver option offers unlimited hospital cover through a network of hospitals, with in-hospital specialist bills paid at 100%. A short list of in-hospital exclusions applies. Day to day claims are paid from a defined benefit pool with a separate benefit for dental claims.
Equilibrium offers unlimited hospital cover through a network of hospitals, with in-hospital specialist bills paid at 100%. A short list of in-hospital exclusions applies. Day to day claims are paid from savings and a defined benefit pool.
Essence is a hospital plan that offers unlimited hospital cover at a network of hospitals, with in-hospital specialist bills paid at 100%. A short list of in-hospital exclusions applies to this option including in-hospital dentistry. Joint replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only).
Origin offers unlimited hospital cover through a network of hospitals, with in-hospital specialist bills paid at 100%. A comprehensive list of in-hospital exclusions applies to this option. Day to day claims are paid from a defined benefit pool.
3. Medshield Medical Scheme
Medshield offers a choice of 11 different plan options:
- MedShield MediCurve
- MedShield PremiumPlus
- MedShield MediValue Prime
- MedShield Value Compact
- MedShield MediSwift
- MedShield MediSaver
- MedShield MediPlus Prime
- MedShield MediPlus Compact
- MedShield MediPhila
- MedShield MediCore
- MedShield MediBonus
The Compact options have compulsory use of networks and care co-ordination, nominating a Family Practitioner and the Family Practitioner-to-Specialist referral process, resulting in cheaper contributions.
Medshield offers an oncology programme for cancer patients, access to emergency services and affordable hospital plans:
MediPlus Prime & Compact
MediPlus offers unlimited hospital cover at a network of hospitals, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of procedures and a short list of in-hospital exclusions applies. Day to day claims are paid from a defined benefit pool with additional benefits available.
MediSaver offers unlimited hospital cover at a network of hospitals, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of hospital procedures and a short list of in-hospital exclusions apply.
MediValue Prime & Compact
MediValue offers unlimited hospital cover at a network of hospitals, with in-hospital specialist bills paid at 100%. Co-payments are applied to a comprehensive list of hospital procedures and a short list of in-hospital exclusions applies. Joint replacements are only covered in the case of acute injury (Prescribed Minimum Benefits only).
This is an unlimited hospital plan to cover In-Hospital expenses for major medical emergencies. MediSwift offers unlimited In-Hospital cover through the Compact Hospital Network, with In-Hospital procedures paid at the Medshield Tariff (100%). As a hospital plan, MediSwift offers no Day-to-Day benefits.
4. BestMed Medical Scheme
BestMed is a large self-administered medical plan, the fourth-largest open medical plan in South Africa.
BestMed has a track record of providing wellness benefits, and cost-effective healthcare coverage options to young and old.
All of its alternatives offer benefits for preventative healthcare, such as treatment for pneumonia, vaccinations against influenza, and a variety of other options.
BestMed Medical Aid Option Plans include the following: xHospital Plans, Network Plans, Savings Plans, and Comprehensive Plans.
BestMed Savings Plans include extensive hospital cover at private hospitals and a savings account out of which general day-to-day expenses are paid.
The following is some options available from Bestmed Medical Scheme:
- Beat2 Savings Plan
- Beat2 Network Savings Plan
- Beat3 Savings Plan
- Beat3 Network Savings Plan
The Network Savings plans are associated with certain Network hospitals and providers.
5. Fedhealth Medical Scheme
Fedhealth is known for its unique benefits paid by risk, which help members get more out of their regular benefits.
Several of the medical aid plans offered by Fedhealth are suitable to fit the needs and budget of pensioners and people over 65.
Older people can choose from a variety of hospital plan options, including coverage if they never had medical aid before. The choice will depend on their health situation, available budget and how they prefer to manage their medical expenses.
Fedhealth is known for an excellent scheme that offers you a hospital only plan, but with the benefit of a day-to-day savings fund that you repay only when you spend them. If you want to have access to funds for unforeseen out of hospital costs, but which you can control, this is a very good choice for a medical scheme for pensioners and people older than 65.
You might like to read more about Genesis Medical Aid
Frequently Asked Questions
Can you join a medical aid if you are a pensioners or receiver of SASSA grants?
Yes, you can join a medical aid if you are a pensioner or over 65. Medical schemes in South Africa cannot restrict membership by age but cost is the main factor for pensioners who may be living on a lower income during the retirement years.
Are there medical aids that cover pensioners and people over 65?
Yes, most medical aids cover pensioners and people over 65. The level of coverage only depends on the option choice that the member can afford.
Is there a waiting period to get covered by medical aid if you are a pensioner or SASSA grant recipient?
Yes, even if you are a pensioner, you will have to wait at least 3 months to receive general benefits. Benefits for pre-existing conditions will only apply after 12 months. If you just switched medical aids, these waiting periods will not apply.
Is there an age limit to join a medical aid?
No, there is no age limit when to join a medical aid. Pensioners can easily get medical aid as long as they can afford the monthly premiums.
Can a 70 year old get health insurance?
Yes, any person can get health insurance, but it will be quite expensive since the risk of certain procedures will be higher.
Is a hospital plan worth it for pensioners?
Yes, a hospital plan can be worth it for pensioners since it still offers benefits when you land in hospital. It can give you more choice around healthcare providers and enable you to avoid a public hospital waiting list and you will be able to get better treatment sooner.
READ more about the 5 Best Medical Aid for SASSA Pensioners