It is hard to find the extra funding to cater for the unexpected hospital or doctors bills. Here is how to get medical aid gap cover that caters to your needs.
Medical aids don’t pay out in full
It is not a pleasant experience to need a specialist cure, but the cost of the service makes the situation even worse.
As such, medical shortfall plan is something you should have. Especially if you do not want to see your savings vanish on excess medical bills.
What is more, you are safer when you get gap cover.
So, what are you exactly covered for by your medical aid? In reality, it’s much less than you think.
Standard practice dictates that your health insurance covers you 100% of the medical aid rates. However, health bills can be much more than that!
There are many places where you can get medical aid gap cover in SA
Sometimes you deal with medical practitioners who think nothing of charging you four or five times the standard rates.
Do not just get caught up in a financial trap by spending all your money on unexpected medical costs. Compare, compare, compare!
Zestlife as an Example
Zestlife as an Example
This is a policy that is relatively cheap since is comes in premiums of between R270 and R600 monthly.
Enhancements for their 2019 Universal option include:
- Overall regulatory maximum for medical expense shortfall cover increased from R150 000 to R160 000.
- Cancer lump sum increased from R25 000 to R30 000.
- Casualty benefit increased from R10 000 to R20 000. Casualty visit must be within 48 hours of the accident.
- Medical Aid and Gap Cover Premium Waiver maximum increased from R6 500 toR7 300.
- Medical Aid and Gap Cover Premium Waiver limited to accidental only, but the payment period increased from 3 to 12 months. This change was due to legal requirements.
- Accidental dentistry maximum increased from R15 750 to R19 250 and amount per tooth increased from R2 250 to R2 750.
- Non-Designated Service Provider co-payment increased from R8 600 to R9 300.
- Oncology co-payment maximum increased from 20% to 25%.
- Cover for robotic procedures up to R30 000.
- Cover for procedures in day clinics.
- New Oncology Benefit to cover 20% of treatment cost when oncology limit is exceeded.
- Varicose veins have been added as an out-of-hospital procedure that is covered.
Zestlife Premiums for 2021
List of other providers:
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All info was correct at time of publishing