The only solution you have for those specialists who charge you far more than what is laid down in the Medical Aid Tariff Price List, is to get customised gap cover. This medical gap cover takes care of the shortfall that exists between what the medical aid will pay and that your unregulated specialist charges.
South Africa has a number of excellent gap cover providers of which Momentum is one. You can get gap cover for a low premium each month which helps you with those shortfalls. Gap cover from Momentum doesn’t only cover gaps as mentioned, but also certain procedures performed out of hospital. Momentum’s gap cover will cover co-payments, and health expert’s shortfalls.
Customised Gap Cover is for Medical Aid Members Only!
Let’s find out a little about Momentum GapCover
- GuardRisk Insurance Company underwrites Momentum gap cover. Guardrisk ise an authorised Financial Services Provider
- If you are on Momentum Medical Aid you can choose from 4 TruGap Gap Cover options –
– Option 1and 2 will only cover PMB claims if you are on the Alternative cover option
– Option 3 doesn’t cover PMB claims but Option 4 does
– Each option offers 400%, except option 2 – up to 500% cover for in-hospital events
– Option 3 is for students and the principal member only pays R89 a month as a premium
- All gap cover policies offer a R50 000 lump sum amount for accidental death or disability
- Those shortfalls Momentum covers are processed automatically. Members don’t have to submit a claim form or documentation
- Premiums for 2018 are between R249 to R449 a month in 2018
- Momentum’s gap cover brand is TruGap – TruGap pays up to 400% for in-hospital events
- Gap cover also covers R1,200 for every admission to hospital, excluding motor vehicle accident or maternity admissions.
- Co-payments –
– R2 030 for CT- and MRI scans both in- or out-of-hospital
– R1 200 on 52 procedures performed in the doctor’s rooms
– 20% co-payment after the limit of R300 000 on Oncology benefit
Waiting Periods with Customised Gap Cover
- There are waiting periods when you apply for customised gap cover from Momentum –
– no standard waiting period
– for pre-existing conditions there is a 6 months waiting period
– 12 months waiting period for cancer, hysterectomy, grommets, tonsillectomies and pregnancy
– 10 month waiting period for specific conditions
- Maximum entry age is less than 65 at next birthday
- R1 million maximum benefit per annum.
Medical aid members can’t be blamed for getting angry with their medical aids when they discover that even with their high monthly premiums, hospitalisation costs aren’t covered in full. Gap Cover is the only solution and Momentum Health’s gap cover is at least as low as it can be.
Complete the form on this page, submit the form and we will supply a gap cover quote
Note: medical gap cover is for medical scheme members only
All info was correct at time of publishing