Paying for medical treatment can be a minefield, who pays what; what are standard rates; why didn’t my medical aid pay the entire bill? Never fear, help is near in the form of Gap Insurance for Medihelp Medical Aid
This help is particularly needed in the hospital, especially if you are having an operation.
Gap Insurance for Medihelp medical Aid – Surely all Fees are standardised?
Most medical aid plans do live up to their promise of paying claims according to standard rates. It’s the words “standard rates” that makes things tricky.
Standard rates are set by the medical aid firms themselves and what they have decided the average treatment or consultation will cost.
Issues develop because the rates actually charged can be quite a lot higher. While you might think that the standard medical aid rates are quite fair, the doctors may not.
And there is nothing to stop them charging what they feel is fair. This could lead to you paying a substantial amount of money even after the medical aid has paid you out 100%. Unless you have Gap Insurance for Medihelp Medical Aid.
The standard rates are looked on more as a starting point than an actual guideline. If there is a shortfall, you are the one who has to pay that extra money.
Protecting yourself against High costs is Quite simple
There are basically two things that you can do. Hope and pray that you never fall ill and go to a hospital. Or you can get gap insurance to help you pay the difference.
Gap insurance specifically covers you for shortfalls when it comes to medical bills. Let us say, for example, that your procedure costs R12 000. Medical standard rates for the procedure are R6 000. This leaves you with a bill for R6 000.
If you have gap insurance, it pays out the R6 000 to you in order to settle the debt.
It is a supplementary insurance that works with your medical aid. It is not a replacement for your medical aid and can work independently of it. What this means is that you can choose different companies to provide your medical aid and your gap cover.
What about Hospital plans?
Hospital plans may seem like an attractive option but can also leave you in the lurch. They normally impose a high fee. Payouts may be limited to a set cash amount rather than based on the bill received. This could still leave you needing to find money for unpaid bills.
Also, you might have to spend a certain amount of time in hospital before you can claim. In the meantime, costs go up while waiting for the hospital plan to pay. Hospital and medical aid plans usually impose far stricter annual limits. Sub-limits can also eat away at your cover in next to no time.
Do I qualify for Gap cover as a Member of Medihelp?
Medihelp is a South African, registered medical aid. As long as you are a member in good standing and meet the age requirements, you should qualify. Not all gap cover providers have limits regarding maximum age so it does pay to do a little homework.
If you are a member of a medical aid scheme, request your medical gap cover quote by filling in the form on this page. Don’t forget to hit the submit button!
All info was correct at time of publishing