Considering the state of South Africa’s government hospitals, you’d think that everyone in South Africa would be on a medical aid plan. Or at least have a gap cover quote in their hands.
The reason many people steer clear of medical aid is that their monthly premiums are too high. For the high premiums they pay, they’re not getting their money’s worth.
The medical aid schemes are not meeting the expectations of their members. That is according to the latest South African Customer Satisfaction Index (SAcsi) survey.
Those who took part in the study all seemed to agree that Bonitas was ranked as the best medical aid to have. The results also showed that medical aid firms weren’t co-operating with their customers. This is why gap cover is necessary. Get a gap cover quote before it’s too late.
Members want Value in exchange for their High Premiums – Get a gap Cover quote
Medical aid companies know that health care policies are a grudge purchase. A survey from Stats SA revealed that only 17.5% of South Africans belong to a medical aid scheme.
The study also showed that between the years 2002 and 2015, medical aid members increased from 7.3 million to 9.5 million. But what are medical aid firms doing to improve the outlook for their members?
They offer lots of unwanted frills and add-ons that simply push up the premiums. Members don’t want add-ons of no value. They want quotes which indicate affordable premiums and quality health care – nothing more, nothing less.
It’s Not Fair – Medical Aid’s not Paying
After all is said and done, being on a medical aid scheme is still a good idea. Because you never know what can happen. You can be struck down in an accident or find out you have a dreaded disease such as cancer.
A medical aid plan can be a lifeline – affording you the chance to have decent medical care and to enjoy a 2nd chance at life.
And yet in spite of South Africa having some 160 medical aid scheme companies from which to choose from, there is a common thread running through all of them – they won’t pay 100% of your medical bills. Some treatments they will only part-pay.
Medical schemes cover most of your medical bills, doctors’ fees, surgery costs, medication and hospitalisation. They pay the agreed on rate. However, some specialists charge way over the standard medical aid rate; you have to pay the shortfall, which could run into thousands.
More About a Gap Cover quote
Gap cover can help you out of this financial predicament. The best part is that it’s an affordable insurance option which you invest in separately from your medical aid, but which supplements it.
You must belong to a registered medical scheme to have gap cover.
When you’re caught off-guard because of medical bills your medical aid won’t pay in full, gap cover steps in and pays it for you, sparing you a lot of money and anguish.
What if you’re Left with Shortfalls in Payment
Because medical aid firms do not pay for specialist fees in full and because medical aid members have to pay co-payments on certain procedures sometimes, South Africans are feeling under threat. Their medical aid plans pay in-hospital costs at 100%, 200 and 300%.
However, what does that help when the specialist charges more than 500% of these tariffs? There’s going to be a shortfall, and you’re the one who has to pay it. That’s if you don’t have gap cover.
South Africa has many reputable gap cover providers. Just a few of the good ones are Zestlife, Essential, Turnberry, Stratum and Complimed among others. They all offer free gap cover quotes. Research them and see the range in monthly premiums they offer – there is something for everyone’s budget.
Why Gap Cover is Necessary
Gap Cover is an insurance product. It’s unthinkable that gap cover, sold by short-term insurance companies, was at one time, almost outlawed. Fortunately, it never was.
Outlawing gap cover would have meant healthy people on low-cost options deciding rather to exit their schemes. Leaving the plan would have driven up the contributions of those who remained with the plan.
When you land up in a hospital, gap cover takes care of the difference between what your medical aid will pay and what the specialist charges. Gap cover could well pay up to a maximum of 600% of your medical aid tariff.
No need to worry about finding the extra costs because gap cover looks after you. There are some gap cover providers who also cover the specialist shortfalls from a defined list of out-patient procedures.
Gap cover does what your medical aid should be doing – settling your medical bills with costly medical experts so that you can remain debt free.
A gap Cover quote Premium Varies to Cater for All
The beauty about comparing gap cover quotes is that you quickly realise how affordable it is. The best policies will not exceed R500 a month for comprehensive benefits for the entire family.
Gap cover isn’t restricted to any particular medical scheme either – it works with any medical aid. You’re able to change your medical scheme without having to change your gap cover.
Gap cover is designed to help you meet the private tariffs that doctors and specialist surgeons charge for in-patient treatments. There will be waiting periods and exclusions with gap cover.
Most gap cover providers have a standard three month waiting period from the date of inception. However, there may be other waiting periods surrounding pregnancy and pre-existing conditions
Exclusions include suicide and cosmetic surgery etc. Some gap cover providers have an entry age limit of 60 years old, some 65 and others allow one to be older. The cover insures you and your family.
Gap Cover – a Useful Top-Up
The plan is not complicated. Rather than overwhelm yourself with stress about a medical aid scheme that won’t pay your bills, make some lasting sensible changes and get gap cover.
When you have medical gap cover from a reputable provider, you won’t have to worry about any surprise bills. If you receive a medical bill, you simply hand it over to the gap cover company that provides you with your shortfall cover.
Medical aid in South Africa may well allow you to believe that you have sufficient cover. They aren’t going to tell you that some specialists charge way over the medical tariff guidelines. Also, if your medical aid says it will pay 100% of the medical aid rates, make sure you understand this. It doesn’t mean your bills are covered in full.
Compare Quotes
Request gap cover quotes from several providers – you’ll find them costing just a fraction of what your medical aid premium is. To get a free gap cover quote, go to any of the gap cover provider websites and complete their online contact form.
Here are the guide prices for Zestlife gap cover in 2025:
A knowledgeable consultant will call you back and discuss everything you want to know. Don’t wait to be handed medical bills that can see you selling off your assets to pay for unexpected medical bills.
Use the form on this page to sign up for gap cover. Complete and then submit the form now to get a quote
