The role of Gap Cover in women’s’ healthcare

Gap Cover bridges the gap between what specialists charge for in-hospital procedures, and what Medical Aids pay. For women in particular, Gap Cover plays a key role in helping one manage their medical and financial affairs.

“In many specialist fields devoted specifically to women – such as gynaecology and obstetrics –costs are escalating,” notes Turnberry’s Wendy Bussey.

Surging costs in areas such as gynaecology and obstetrics result from medical inflation in areas like medical malpractice insurance.

In a recent column, South African Minister of Health, Aaron Motsoaledi, noted the following. “About eight years ago, obstetricians and gynaecologists paid R78,000 a year for insurance. In 2017, the Medical Protection Society’s insurance costs R800,000 — an increase of 925%.”

Gap Cover Plays a Key role in Obstetrics

Bussey notes that some gynaecologists withdraw from the obstetrics field due to the high insurance costs. So there are ever fewer practising obstetricians, which only adds to the inflationary effect.

Wendy Bussey of Turnberry
Wendy Bussey of Turnberry, the Writer of the Article

Bussey notes that Turnberry has sadly seen a sharp rise in womens’ cancer claims over recent years. And Turnberry isn’t the only medical insurer to note this trend. A Discovery Health report shows an astonishing 45% rise in cancer claims between 2011 and 2017, and noted breast cancer as one of the most common types of cancer claims.

“All of this means that women are very vulnerable to medical expense shortfalls,” she explains. As a result gap cover plays a key role in childbirth because gap insurance covers medical aid shortfalls.

Often, these common claims from women extend further than just the initial diagnosis and treatment. Breast cancer, for instance, isn’t just about the removal of the cancerous tissue, but it also includes the reconstruction afterwards.

Ways in Which Turnberry Gap Cover Plays a Key Role

Bussey explains that your Medical Aid and Gap Cover combination needs to cover the entire spectrum of medical procedures and services that you may need: “In Turnberry’s case, we don’t just fund the medical expense shortfalls for breast cancer surgeries, but we’ve also assisted members when their oncology benefits have been exhausted for traditional and biological cancer drugs.”

In childbirth, there may be circumstances where the new-born baby needs neonatal ICU or in-hospital observation over their first few days of life – or perhaps something even more serious like a heart condition requiring immediate surgery.

Bussey points to a Gap Cover claim from earlier in 2018 – for almost R92 000 – for a baby born with a rare medical condition. “For a family that is welcoming a new baby, and all the additional costs that brings, an out-of-pocket expense of close to R100 000 is very difficult for most households to endure.”

Fortunately, for that family, Turnberry covered the medical expense shortfall.

When asked about some of the other common claims from women, she notes an increase in the number of women needing treatments for ovarian cysts, endometriosis, fibroids, dilation and curettage – as well as procedures like hysterectomies, laparoscopies, hysteroscopies.

“The health of our women is fundamental to the happiness and prosperity of our families, and ultimately of our broader society,” adds Bussey, “it’s absolutely critical for women to look after their health, supported by a quality Medical Aid and Gap Cover that’s geared to their unique needs.”

Wendy Bussey, Business Development – Gauteng at Turnberry Risk Management Solutions


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All info was correct at time of publishing