Here is where you can get the form for claiming from Zestlife.
What the Company Does Not Pay For
Zestlife pays only for treatments related to your stay in a hospital. If your medical aid rejects your claim, Zestlife will not pay for it either.
That is because this cover is to cover the gap. The gap between what your medical aid pays out and what your bill is during your time in a hospital.
If the medical aid rejects the entire claim for some reason, Zestlife will not pay out. It supplements your medical aid. It does not completely replace it.
Let us say, as an example, your operation costs you R30 000 and the medical aid pays a total of R15 000. When that happens, Zestlife will cover the remaining balance.
Do Your Research Up Front
It is important to understand what the terms and conditions of your medical aid are as well. In most instances, if you do not act in accordance with these, you might find that your medical aid rejects claims.
It is just as important that you understand what your cover does and does not include before taking the policy out. You do not want to end up in a situation where your gap cover claim will be rejected.
Be sure to read out the terms and conditions relating to the policy first. If there is anything that you do not quite understand, be sure to ask about it.
Be sure to check what waiting periods apply to your cover and what exclusions, if any, there are as well.
Form for Claiming from Zestlife
For example, the Zestlife Cover includes the following procedures:
- Zestlife will pay for abscess drainage in some cases
- Some hernia repairs, namely, femoral hernia, inguinal hernia, epigastric hernia, umbilical hernia, Spigelian hernia
- Zestlife will pay for breast lump biopsies conducted during surgery
- A haemorrhoidectomy will is paid for in certain circumstances
- Biopsies of lymph nodes and Biopsies of the prostate gland
- Cystoscopy and Vasectomy and Orchidopexy
- Zestlife will pay for colostomy closures
- Removal of cataracts and Removal of pterygium
- Tonsillectomy and Trabeculectomy
- Certain surgeries related to sinus issues, such as functional and bilateral functional endoscopic surgery and frontal sinus surgeries
- Grommets and Myringotomy
- Carpal Tunnel Release and Arthroscopy
- Ganglion procedures and Bunionectomy
- Liver biopsies and Angioplasty
- Bronchoscopy and Oesophagoscopy
- Enteroscopy and Tubal Ligation
- Childbirth treatments in and out of hospital
- Treatment of Bartholin’s Cyst and ablation of the cervix using a laser
- Dilation & curettage and Colonoscopy
- Hysteroscopy and PET scans and MRI scans and CT Scans
Cancer Treatments
What is very important to note is that radiotherapy or chemotherapy related to cancer treatments that you have as an out-patient will be paid for.
Zestlife will also pay for kidney dialysis treatments, even if conducted as an out-patient.
Other treatments that you have as an out-patient and in a hospital may also be included if Zestlife agrees to them. Check up front if you have any concerns about any other procedures.
Your gap cover policy can help to stave off significant debt and give peace of mind when it comes to emergency and disease-related treatments as long as you follow the rules.
If you have to claim, use an official form for claiming from Zestlife.
Get your gap cover quote by completing and sending the form on this page
