What are the Differences Between Medical Aid Plans that Require Hospital Network Use and Those That Do Not?

The role hospital networks play in your medical aid

At its simplest, a hospital network is a group of private hospitals that your medical Scheme has partnered with. These partnerships are built around agreed tariffs and care protocols, which allows the Scheme to manage costs more effectively.

When you select a plan that uses a network, you are choosing to receive hospital care at one of these designated facilities. In return, the Scheme can offer lower monthly contributions because it has greater control over how and where costs are incurred.

Plans that do not require the use of a network facility, work differently. They give you the flexibility to choose your hospital, which comes with a higher contribution that reflects that freedom of choice.

From a member perspective, both approaches provide access to private healthcare. The difference lies in how structured that access is.

 

How network hospital plans work in practice

A network-based plan is built around a clear, practical trade-off by using a defined group of hospitals for planned admissions, you benefit from more affordable cover.

This is why network plans are often positioned as a smart entry point into medical aid, particularly for younger professionals or those looking to manage monthly costs more carefully. Profmed’s own ProSelect and Savvy options follow this model, offering unlimited hospital cover within their respective networks at a lower contribution level.

Each option has its own network. ProSelect uses the ProSelect hospital network, while Savvy uses the Savvy network, giving members a choice based on their specific needs.

Because these hospitals have agreed to specific pricing structures with the Scheme, the overall cost of care is more predictable. That predictability is what supports the lower monthly premium.

In an emergency, you can go to the nearest hospital, and if a suitable network hospital is not reasonably accessible, alternative arrangements can be made.

 

What plans without hospital networks offer

Plans that do not require the use of a hospital network allow you to choose your hospital when you need hospital care, which introduces a greater degree of flexibility into your healthcare journey.

This flexibility is often valuable for members who travel frequently, have established relationships with specific specialists, or prefer access to a wider range of facilities.

The structure of these plans reflects that freedom. Without the cost controls that come from directing members to specific hospitals, contributions are higher.

For many professionals, this becomes a lifestyle decision as much as a financial one. It speaks to how much control you want over where you receive care, and how much you are prepared to pay for that flexibility.

 

Understanding the real decision

When comparing these options, the question is less about which one is better, and more about which one fits the way you live and use healthcare.

A network plan works well when:

• You are comfortable planning your care around a defined group of hospitals
• You want to keep monthly contributions as efficient as possible
• You are early in your career or building financial stability

A non-network plan aligns more closely when:

• You value the ability to choose your hospital freely
• You travel often or move between cities
• You want broader flexibility in how you access care

In both cases, the core hospital benefits remain robust. The difference lies in how structured the journey to accessing those benefits becomes.

 

How Profmed approaches hospital networks

Profmed’s approach to hospital networks is deliberate and member-focused. The Scheme works with selected private hospitals that agree to negotiated fee structures, which supports affordability without compromising on quality of care.

To find out more about Profmed’s plans, contact degree@profmed.co.za