FAQ About Admed Gap Cover

Medical Aid Schemes are no longer able to cover members comprehensively against rising medical costs. This is mainly due to the lack of Government controls on tariffs raised by Specialist Practitioners, and private medical facilities. In this article, we answer some of the most FAQ about Admed.

Did you know?

Tariffs are often five times higher than standard medical aid rates. That will leave you with the medical shortfall, which you have pay for out of your pocket.

Insurance companies now offer gap cover

FAQ About AdmedSome insurance companies now offer Gap Cover to medical Aid members. To bridge the shortfall between what the Medical Aid will pay out and what the Specialist Practitioner or Private Healthcare facility will charge. When have gap cover, you have peace of mind. Admed is a Gap Cover Service Provider, with a comprehensive range of products tailored to meet the growing need of Medical Aid members. We are the ideal solution if you are want to cover shortfalls on medical aid claims.

FAQ About Admed

Learn more about the benefits of Gap Cover offered by Admed, through the following questions and answers:

Q1. Anyone can get Gap Cover from Admed

Admed can only offer services to members of a South African Medical Aid Society.

Q2. Do you cover out of hospital procedures?

Yes, a list of out-of-hospital procedures that are covered and the respective limitations and conditions are included in each Admed policy.

Q3. Is the cover immediate?

There is a three month waiting period until cover takes effect. Certain exclusions and extended waiting periods for pregnancy and pre-existing conditions.

More FAQ About Admed

Q4. Are there any age restrictions?

We exclude applicants older than 65 unless they are a member of a Medical Aid scheme through a Group Employer. Although we do not offer cover to dependents or spouses older than 64.

Q5.What additional benefits can I expect from Admed?

Admed offers a comprehensive range of benefits:

Co-payment cover for certain specified procedures, which also includes oncology treatment programmes.

Lump Sum pay-outs under certain given circumstances:

  • Accidental death.
  • Permanent disability.
  • Initial cancer diagnosis.
  • Long term hospitalisation.

Gap cover on internal prosthesis costs.

A fixed benefit for dental treatment necessitated through accidental injury.

Q6. How much does it cost?

Get a quote on this page.

Q7. What is the claims procedure?

You will have to submit your claim to Admed. These are paid out directly to the member, within 7 – 10 days. Claims older than six months become void.

Q8. Does Admed have a good claims record?

Admed recent met the shortfall on Cardiac By-pass surgery amounting to R45 931.02, standing testament to their excellent record!

Q9. Can I terminate the Policy?

This question a lot with FAQ about admed. Yes, policies can we cancelled at any time, on giving one month’s written notice

More FAQ About Admed

By reading the FAQ about Admed, you are now more well informed about what you will get from Admed.

Fill in and submit the form on this page to get your one free gap cover quote

Published:

Updated:

Latest posts

  • Get Medical Aid Shortfall Cover with Ambledown Today – Stay Covered

    More often people are shocked when health insurance covers fail to foot the entire hospitalisation costs. However,  you can learn about Ambledown medical shortfall plan that helps bridge the gap. Ordinarily, health covers have set limits and pay out accordingly. However doctors impose rates higher than the medical tariffs, and consequently, patients end up suffering…

    Read more

  • Making a Gap Cover Claim from Sanlam

    If you have a gap cover from Sanlam, you might be required to be making a gap cover claim from Sanlam following a hospital visit. But what is gap cover? While making a hospital visit is not something you will want to consider, it’s not something that we expect to happen. Hence, only a few…

    Read more

  • Gap Cover for the Primary Medical Aid Member – Stay Covered

    The Main Medical Aid Member Should Consider Gap Cover The last you want to see is a pile of unpaid bills after visiting the hospital during recovery. As such, that is why you require a gap cover for primary health aid members and their dependents. Ten or twenty years ago, one could have been completely…

    Read more

Share via
Copy link