Medical aid Members need More than just A medical Aid plan.

Gap cover for main medical aid members is a backup plan you need to have. Because, when recovering from a stay in a hospital, you don’t ever want to think about being back there again.

That becomes very difficult when you have doctor’s accounts to pay.

A couple of decades ago, this wouldn’t even have been an issue as your medical aid covered all costs. However, things have become a lot more complicated since then. Now, your healthcare will pay 100% of the bill, as long as standard tariff rates apply.

Gap cover for Main medical Aid Members

Gap Cover for Main Medical Aid MembersMost professionals, who normally charge three or four times the standard tariff rates, don’t consider standard medical aid tariffs high enough.

The medical aid firm does fulfil its side of the bargain. They pay 100% of the tariff rates, but you might end up paying more than they do towards the bill!

Even the Odds with Gap cover

You can’t outrun those odds. Either you settle for treatment that is less than the best, or you try and raise the money.

Want something to even up the odds? Gap cover will do that for you. Gap cover pays for the shortfall your medical aid payment creates.

Here’s an example of one such product so you understand the others better.

Admed gap Cover and How it Works

You have cover for the times that you need to stay in a hospital and for certain outpatient procedures.

Admed will pay the shortfall not covered by medical aid. This cover is limited to double the amount paid by your medical aid.

If you had a procedure, for example, and you got the following account:

Anaesthetist: R16 000.

Standard medical tariff: R5 000.

Your medical aid pays R5 000 and Admed pays double what your medical aid does so they pay R10 000.

At the final tally, Admed pays most of the expenses. There is still an R1000 shortfall that you have to pay. But R1000 is a lot better than having to pay R11 000?

Admed – Gap cover for main medical aid members

This is the top of the range cover. The benefits include:

  • Cover for the payment of medical professionals
  • Deductibles and co-payments may be covered.
  • In respect of oncology expenses, Admed will pay the co-payments
  • Admed will pay the costs for oncology treatments in full if you have exceeded your annual limit
  • A cash sum is paid out by Admed with your first cancer diagnosis
  • Admed does include internal prosthesis
  • You receive a lump sum for an extended hospital stay
  • Admed will pay out an accidental death benefit and a permanent disability benefit
  • There is some cover for dentistry but only when needed because of an accident
  • Emergency room visits are covered

Admed primary Gap cover

This is a basic package. You get the following benefits:

  • Cover for the payment of medical professionals
  • Deductibles and co-payments may be covered

Get a FREE gap cover quote here, just fill in the form on this page

All info was correct at time of publishing