South Africans are not happy with their medical aids. They pay large monthly premiums, yet their schemes do not cover their costs in full. Hence, they are looking for answers to medical gap cover questions.
Further, in addition to their costly monthly premiums, members find that they have to obtain gap cover in order to fully meet their medical obligation without digging into their savings.
Indeed, questions have arisen as to what gap cover is and why it is such an essential “must have” when one already has medical aid.
In essence, gap cover is an insurance product that aids in paying for your health treatments that medical aids can’t cover in full.
Gap cover is only available to people who are already on a medical aid plan. Since it only covers for shortfalls after the medical aid has paid out their portion of the benefit.
A principal member is free to add onto their gap cover, beneficiaries that include their spouse, children, parents and other family members.
To qualify, you must be a member of a listed medical aid. Further, you can change schemes without losing your gap cover.
Medical Gap Cover Questions: Why is it Crucial?
Medical gap cover is vital since the cost of medical treatments in South Africa by far surpasses what the medical aid plans can afford to pay.
The Council for Medical Aids prescribes minimum benefits payable for members.
Medical experts and private hospitals, on the other hand, charge what they want, because their prices are not regulated.
As such medical bills may run into 500% more than what the medical aid can pay for. This is why gap cover is vital. It pays the difference so that you don’t have to.
Medical Gap Cover Questions: Where can I get Gap Cover?
There are many organisations that provide gap cover insurance. They are mostly independent of any medical scheme.
As such, when you decide to change your medical aid plan you still get to keep the gap cover.
Further, there are organisations that provide medical aid cover who will also provide gap cover which is in line with the packages they offer.
Brokers designed gap cover to pay the shortfall left by the medical aid. Yet gap cover will not pay for certain procedures.
These include health treatment that is a result of unnatural causes such as cosmetic surgery and suicidal attempts.
The requirements for you to have gap cover will vary dependent on service provider.
Hence, you have to find a gap cover with a premium you can afford and fits your needs.
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All info was correct at time of publishing