Our expert says:
Your primary dilemma seems to relate to cost versus benefits.
Most medical schemes started out offering access to any hospital anywhere enabling you to select the surgeon of your choice – but relatively speaking these were far more expensive. Providing access to a network was seen to be a competitive advantage as it reduced price without compromise in care. The primary objective of a scheme is provide the best possible health care for its members, so when a restrictive list is provided those hospitals and services are generally selected because they provide good quality healthcare at affordable rates. By limiting the network of hospitals medical schemes can also negotiate keener rates for the procedures performed at those hospitals.
Therefore, most schemes have offered the middle road solution, where they have a preferred provider network of hospitals. However if you want to go to your own hospital, some medical schemes cater for this by imposing a levy which would be payable by you.
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