Gap Cover and its Legal Standing

Many people have questioned the legal standing of gap cover.

This was largely due to confusion with regards to what gap cover is and its purpose.

However, the government is implementing new legislation in 2017 to correct this mix-up and bring added benefits to users of medical gap cover.

What is Gap Cover

Many people believe that their medical aid will cover them for all health costs they face.

They are shocked when the bill arrives, and they realise their scheme does not fully cover them. Luckily, gap cover offers added protection for such cases.

Gap cover is not the same as a medical aid. It is a cheap add-on to normal health cover.

Legal StandingGap Cover’s Legal Standing

Below you will find these new legal changes regarding your gap cover.

Continued Operation – One of the first and most crucial things you need to know about the new regulations on gap cover, is that it allows gap cover policies to continue operating.

Without these new strict rules, gap cover policies would have ceased to exist. Many factors added to this decision, and the most vital thing to know is that gap cover can still be used despite all the changes.

Payout Limits – Gap cover policies may only pay amounts out up to R150 000 per client per annum. The government created this legislation to decrease harm caused to medical scheme aids.

Experts also believe that medical specialist often charges higher rates since they know a patients gap cover will pay out beyond their medical aid scheme.

This will also be prevented by the limitation on payout amounts and increase competition in the medical field regarding costs. The cap on gap cover will increase by CPI every year.

Age Limits – Gap Cover is now also available to members over the age of 65. This means a lot more people can benefit.

“Before you couldn’t get gap cover after the age of 65. Regulations now remove that exclusion.”— Paresh Prema (Head of the Medical Benefits Management Unit)

Coverage Expanded – Gap cover pays for a lot more, thanks to the new legislation. Gap insurance now also covers certain cancers that basic medical aids don’t.

In Conclusion

Although some may see these new changes as an inconvenience. In the long run, they will be greatly benefitted from.

Make sure that your medical gap cover provider explains these new changes to you.

Ask all necessary questions to ensure that you understand these new laws.

Apply for a Gap Cover Quote. Just fill in and submit the form. It’s FREE!

All info was correct at time of publishing