What’s the difference between public and private healthcare? It’s a question asked by many people when they choose to save money by opting out of medical aid or health insurance.

While public healthcare is available in South Africa, many specialised medical facilities are facing challenges and many government hospitals or clinics are under-resourced, which may affect the quality and timeliness of the medical care you receive, should you choose to use public healthcare. Bloom, along with Momentum Health4Me, takes a candid look at the difference between the public and private healthcare sector in the country.

Find out what the benefits of having private health insurance looks like so you can make an informed decision about healthcare options.

The state of public healthcare in South Africa

All South African citizens are guaranteed access to public healthcare under our Constitution. Unfortunately, the healthcare system in this country faces numerous and ongoing challenges that sometimes impedes the quality and efficiency of healthcare provided to patients. The South African government continues in its efforts to invest funding and resources into healthcare in an effort to increase the number of healthcare personnel and resources at hospitals and clinics around the country. There’s also discussions underway about a National Health Insurance Bill (NHI), the objective of which is to provide universal access to all the country’s citizens.

The reality of the matter is that the government healthcare sector serves more than 80% of South Africa’s 59 million population and the current infrastructure and operational system is severely under-resourced. It could take years before notable improvements are made. Likewise, the National Health Insurance Bill is yet to be passed and is currently still being discussed in Parliament. Some provinces in particular, like the Eastern Cape, have a severely compromised healthcare system and are reputed to be in a crisis situation or on the verge of collapse.

Given the strain on the country’s public healthcare resources, it’s advisable to consider some form of medical aid plan or health insurance policy to cover you and your loved ones in case of a medical emergency or if you need specific medical care.

Why health insurance is the most affordable option for cash-strapped South Africans

Health insurance is the affordable alternative to medical aid plans. Many South Africans are not in a position to afford medical aid premiums due to unemployment and the high cost of living. This is the reason Momentum, a stalwart in the medical and healthcare industry, teamed up with Bloom, to offer quality medical care options to those South Africans who fall into a lower income bracket or who are living on a fixed income. Medical insurance is governed by the Short-Term Insurance Act and covers a list of preselected benefits with a monetary value attached to each of these. The plans are best for day-to-day benefits with some in-hospital benefits and access to private hospital facilities in the event of an accident or emergency.

Benefits of health insurance

One of the main advantages of medical insurance is that your policy will reimburse you for the costs of a medical illness, condition or event. Members will also receive access to top-quality professional medical care and services. Take a look at some of the benefits that come with having access to private healthcare through medical insurance:

1. Shorter waiting periods

Public health often has backlogs at emergency centres and hospitals, which means you won’t receive treatment when you need it most. Private healthcare, in contrast, can accommodate patients far more expeditiously and emergency treatment is prioritised according to the severity of your condition.

2. Specialist benefits

Private healthcare will afford you access to a number of specialist benefits, like gynaecology and psychiatry should you require specialised medical care. This benefit is supported by the Momentum CareCross Network of medical specialists, assuring you top-quality care in these respective fields of medical specialty. Public healthcare in contrast, may not have the required specialist available, which means you would have to travel to a facility that does or go onto a waiting list.

3. In-hospital benefits

Health insurance offers in-hospital benefits for accidents and emergencies. The in-hospital insurance products include different options for in-hospital benefits, like hospital cash plans. A hospital cash plan, like those offered by Health4Me, pays out a fixed lump sum to the member. This payout covers the cost of lost income and expenses associated with the health event that is related to the accident or an emergency, as well as pregnancy or childbirth, and is not always directly related to the medical expenses itself.

4. Chronic medication benefits

There are many illnesses or conditions, like diabetes, where a person will need to take chronic medication for an extended period of time. Health4Me health insurance will cover the cost of your chronic medication, provided it has been approved and prescribed by a network GP and is from the list of 26 chronic conditions.

5. Accident and emergency benefits

Receive private medical care if you’ve been involved in an accident or an emergency, like a car crash or if you’ve suffered a heart attack. You will receive transportation, stabilisation and immediate emergency-response treatment. You will also be admitted to a private hospital, who will then send the account directly to Momentum for payment. The cost will cover up to the benefit option per event limit for casualty treatment and up to the benefit option per event limit for in-hospital treatment, provided the treatment is linked to the respective accident or emergency.

6. Maternity benefits

Medical insurance with maternity cover will offer expectant mothers a number of maternity benefits, like 2D scans, prenatal vitamins and support from leading parenting partner, Baby Yum Yum. If you decide to give birth in hospital, health insurance will provide a maternity lump sum to cover the birth. Additionally, the in-hospital cash benefit for pregnancy matters will pay out a daily amount for each day the mother spends in hospital (provided it does not exceed 48 hours).

Health4Me healthcare benefits

• Have additional healthcare savings
• Include your spouse and children on your plan
• Use a network of approved doctors or specialists
• Have MediPost deliver chronic medication to your door
• Receive comprehensive maternity cover if and when required

Build and save with Health4Me health insurance

Health4Me health insurance is made even more affordable by allowing members to create a customised plan that suits their budget. Bloom uses the building block approach for the Health4Me Bronze, Health4Me Silver and Health4Me Gold plans. This means you get to choose exactly what benefits you wish to be covered for relative to your available budget. The Bronze health insurance plan starts at just R570 per month.

Private medical insurance in South Africa with Bloom

Bloom provides quality health insurance through Momentum Health4Me in the Gold, Silver and Bronze plan options. If you want to know more about the benefits of private healthcare and our health insurance plans, you can do so by contacting our team of brokers who can explain which health insurance plan would suit your individualised medical needs and budget and provide you with Health4Me medical insurance quotes.

Get affordable and comprehensive health insurance for quality healthcare when you need it most.

You may also be interested in our piece on how NHI will affect healthcare in South Africa.

Medical Content Disclaimer

You understand and acknowledge that all users of the Bloom website are responsible for their own medical care, treatment, and oversight. All content provided on the website, is for informational purposes only and does not constitute medical advice. Neither is it intended to be a substitute for an independent professional medical opinion, judgement, diagnosis or treatment.