Unexpected medical bills can be a financial nightmare especially when they run into thousands of Rands. Which is why everyone should buy medical shortfall cover.
It provides the solution to unexpected specialist bills, and it’s cheap. Premiums start from below R200 a month.
Further, it provides cover for the entire family. You really can’t afford to be without some form of backup plan like gap cover.
Why should I buy medical Shortfall cover – I have medical aid?
Consumers mistakenly believe that if they have medical aid, they are fully covered for hospital treatments. Nothing could be further from the truth.
Health schemes work to a set standard of payment ceilings for different hospital procedures.
These payments can be up to 500% less than what the health expert charges for their services.
So the aid member is responsible for covering that 500% shortfall!
Gap cover bridges the difference between what a medical scheme will pay for and the amount charged by the health profession.
Depending on the cover you have chosen, it will pay up to 500% above medical scheme ceilings.
Do you Qualify for Gap cover?
All members of a listed South African medical scheme qualify for gap cover.
It is a form of short-term insurance that covers the main member plus his wife or life partner and children, including adopted and stepchildren.
Who provides Gap cover?
There are dozens of short-term insurance companies in South Africa that offer gap cover. Consumers can select the of cover for less than R200 a month to cover the pricing difference between medical aid tariffs and private experts costs.
Comprehensive gap cover policies range between R274 and R521 a month but include co-payment and sub-limit benefits, as well as cancer treatments.
Some gap Cover examples
- Liberty– covers the main member and all dependents. It pays up to 500% of medical scheme tariffs for hospital procedures and up to 50 out-patient procedures. Other benefits include a once-off payment of R25 000 for first-time cancer diagnoses
- Multi-Prof– is a short-term insurance brokerage whose clients are professionals such as architects and engineers. Gap cover is available up to the age of 65 years. Premiums are extremely affordable around the R100 a month mark.
- Zestlife– offers three options. Policies cost around R300 a month, depending on the option selected
Where do I begin?
There are many gap cover search engines on the internet. The internet gives applicants the chance to shop around in the comfort of their homes.
Pricing and benefits can be compared before making an informed decision about which policy best suits their needs. Users can even apply for gap cover online.
All gap cover policies have co-payment and exclusion clauses. Co-payments are the portion of the cost to the medical aid member for hospital admissions and certain hospital procedures.
Further, these co-payments can be paid by gap cover for an extra premium. Also, exclusions are pretty standard throughout the industry and include, among others:
- Drug and alcohol abuse
- Illnesses related to nuclear fallout or weapons
- Injuries or deaths during riots, strikes and civil uprisings
So do you want to buy medical shortfall cover?
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All info was correct at time of publishing