A short explanation of gap cover. With the high rate of crime today, being a member of a medical aid has become important.
However, if something happened to you, would your medical aid pay 100% for all your hospital bills? Are you sure? What if one of the major illnesses strike and you require hospitalisation for months? Will they still pay?
Actually, they won’t. That’s why there is gap cover.
An Explanation of gap Cover and the Importance of Having it
Without medical aid, where will you get the financial assistance you need to take care of all the bills associated with these events?
Medical aid members are discovering that their medical aid plans aren’t helping as they should either. When the specialist in hospital charges way beyond the regular medical aid tariffs, they won’t pay and its the patient who has to pay.
The explanation for this is, medical aids will only pay the standard medical care rates, and not what a specialist will charge.
Specialist rates are Different to Medical aid rates – You pay the Shortfall
Medical aid rates are those amounts your health care plan is prepared to pay for a particular service. Each scheme has its own Medical Scheme Rate according to the National Health Reference Price List (NHRPL).
Specialists do not abide by these standards; they charge the rates they set.
Take into Account Waiting Periods
You must remember that with both medical aid and gap cover, it’s always wise to take out cover ahead of these unexpected events as there are waiting periods for certain claims.
Your medical aid may well contribute to some medical fees, but it won’t provide coverage for the entire bill. This will leave you with some gigantic bills to settle. Often people discover the limitations of their medical cover too late.
They find that everything covered at a 100% doesn’t mean comprehensive cover at all. Your medical aid only pays out in keeping with the medical aid tariff list, and the problem comes when the specialists charge their rates.
Gap Cover to the Rescue
Your gap cover policy will take care of the excess amounts. Where medical insurance covers only a certain percentage of the invoice, gap cover steps in and covers the rest. Gap cover can provide up to 500% more than the medical insurance does.
Remember that you can only benefit from gap cover if you belong to a registered medical aid. You cannot take out gap cover without medical aid.
What you invest is what you will get out. Do research because you can get medical gap cover for R80 a month, but you can also get gap cover which is R400 a month. Compare and discover which each one covers.
It makes no difference which company you get your gap cover from. South Africa has top gap cover companies such as Stratum, Zestlife, Complimed, Turnberry, Ambledown and many others.
Explanation of Gap cover and So many good Reasons for It
Members of medical aid schemes run the risk of expensive shortfalls for their account. Medical gap cover covers your whole family, and the cover the provide can be 5X over the Scheme Rate.
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All info was correct at time of publishing