You definitely need gap cover if you are on a medical aid

If you get gap cover for hospital plan in addition to a Medical Aid Hospital Plan, you will never have to pay for your medical expenses yourself.

That includes any extra payments that a specialist may charge.

Gap cover for Hospital plan – There is Always a Shortfall

Avoid those extra costs that a hospital plan does not cover, get gap cover for hospital extras. You will save yourself a lot of money in the future. Here are some other things to remember when you only have a hospital plan.

Gap cover for Hospital planDisadvantages of just having a hospital plan:

  • With a hospital plan, there is a chance you will still have additional expenses, if you also have gap insurance, it will pay for these shortfalls, not you.
  • Hospital plans state that they cover 100% of a hospital stay. This means they pay 100% of expenses as per their agreed tariff with the hospital. Any shortfall that exists, you will have to pay.
  • If members choose to use a non-network service provider, there can be extra costs. It is possible that some Gap Insurance policies may cover this.
  • They often require co-payments regarding the hospital plan.
  • Some plans, especially cheaper options, can cap the hospital bills annually.

What is Gap Insurance?

  • Medical Gap Insurance is a short-term insurance policy.
  • Applicants must be a member of a medical aid scheme to have gap cover. Run through this list to ensure you belong to a legitimate medical aid.
  • Gap insurance is for when there are shortfalls from medical claims.
  • Specialists and doctors are not obliged to use standard rates and will often charge much more than the amount a hospital plan will allow. They can charge up to 3 times the rate.
  • Medical aid firms require upfront co-payments for some medical procedures carried out in hospitals. Gap insurance will pay this.
  • Hospital excess benefits are included in some Gap policies. This will normally settle the amount that requires payment to a hospital once reaching the cap of a Hospital Plan.
  • Many healthcare plans are capping Cancer payments as these are becoming a significant drain on funds available. Some Gap policies offer a Cancer Sub-Limit within the policy.

Advantages of Gap cover For hospital Plan

  • Very reasonable rates. Cheap Monthly premiums which can be as little as R150 a month.
  • Covers shortfalls from both hospital rates and specialist fees.
  • One policy will cover the whole family as long as all the dependents are on the member’s medical aid.
  • Peace of mind knowing that the policyholder can always provide the best hospital care for both them and their families.

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All info was correct at time of publishing