Around as many as 85 % of all South Africans don’t possess health cover of some sort. This situation holds huge health hazards to a myriad of people. In this connection the State has introduced a National Health System (NHS) to be implemented over 14 years, which will be available to all South Africans. This system will offer health cover by virtue of further tax to be levied.

The ultimate model has not been announced but it is predicted that health care will either be free or on a sliding scale depending on income levels. It is imagined that all hospitals, including private hospitals, will be available to everyone. This is to be lauded in a country where health care is not available to many individuals, largely as a result of cost and affordability of such services.

Up until the NHS is implemented, and functional, the affordability by many people of health cover persists. As a way to address the matter of affordability, medical aid schemes have developed several models of health cover, that offers varying levels of benefits. However, comprehensive health cover remains for the few fortunate. Hospital plans, which one can find at a discount of about 50% to the full and comprehensive health cover schemes offers a relatively affordably option that addresses at least the very pricey surgical and hospitalisation factors. Fairly recent legislation further sees to it that a number of chronic conditions are also part of such scheme. This means that medication for such chronic illnesses is to be paid for by the scheme. Each scheme has to publish a list of offered medication for which it will pay on prescription.

More comprehensive schemes also offer the normal medical assistance in addition to the hospitalisation aspect but are far more expensive dependant upon the options chosen. Many of these schemes also introduced a savings plan, whereby unused allowances on doctor visits can be saved. Should the allowance, on the other hand, be exhausted, you need to pay for such visits out of your own pocket. The unfortunate thing is that in the end of the day the full cover options do not allow so much more benefit for the charges levied. You, thus need to very carefully research the individual offerings to make sure that you get the most bang for your buck.

Generally, the younger you are the less you will need a very in depth medical cover scheme, but the older you are the more the price issue regarding the more detailed schemes. Companies, while you work, frequently contribute 50% of the cost of health cover, but such benefits very often cease on retirement, so you will be liable for the total contribution.

As soon as the NHS is functional it will bring relief for many. The NHS will continue to operate in a referral system where the day clinic (general medical services) will make reference to regional hospitals (limited specialist services) which will refer to the tertiary hospitals where full specialist services are offered. The Government has recently announced a multi-billion Rand improvement program to the existing facilities to bring them in line with the requirements of the NHS.

For more information about health cover and also legal questions, click the relevant link