Medimed is a great medical scheme, but they will not always be able to pay your health bills in full. That is why Gap Cover for Medimed Medical Aid members is so vital.
Just like with other medical schemes, Medimed won’t be paying for all your treatments – those above the standard medical scheme tariff guide will be your problem.
Gap cover for Medimed Medical Aid members is available to pay for the amounts the medical scheme won’t pay.
In most instances, private hospitals and specialists will charge you more than what your medical aid will cover, and that’s what is known as medical shortfall. Instead of you paying the excess amount, gap cover will.
The rate the medical aid schemes pay for when you are in the hospital and the rate the service providers charge are worlds apart.
Medical aids charge at medical scheme approved tariffs, but your medical service provider will often charge much more for their services. This huge difference is what you will be responsible for.
When you receive your in-hospital account, you’ll notice the prices of procedures done are 2 or 3x more than what your medical aid scheme pays.
Many people think that they are fully covered by their medical aid because, after all, it says 100%. They are unaware of the Gap between what schemes pay out and experts charge. Hence, members find themselves in a frightening financial predicament.
There’s a Solution
Medimed offers gap cover from Complimed – not a medical scheme but an insurance product. Complimed pays the shortfall.
Actual benefits paid are subject to a maximum of 300% of the scheme tariffs, according to the policy. Even though your doctor does charge more than this, you are still responsible for covering the additional amounts yourself. This is why it is important these days for you to discuss the best rates with your specialist to avoid nasty surprises.
Gap Cover for Medimed Medical Aid.
If you’re a medical aid member, you need gap cover. You can apply by completing the Complimed application forms online and then faxing it to PROVIDENCE (041) 395 4590. They will collect the R75 from you monthly and then pay it over to Complimed for you.
PROVIDENCE also assists you in the claiming process once you have been in the hospital. Find out more about gap cover call the Medimed Customer Care group at (041) 395 4474.
Fill in and Submit the Form to receive a FREE Quote!
All info was correct at time of publishing