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
Some 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?
Admed offers two primary Premiums which are billed monthly at the following rates for 2017:
Primary Gap Cover R196.00 per month
Supreme Gap Cover R242.00 per month
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
All info was correct at time of publishing