Good health is a vital part of life. People want to ensure that they remain in good health, and if they fall into poor health, that they can get proper medical attention. As such medical aid cover, even in its most basic form, becomes crucial. Over-insurance for medical cover is even more so. There are various options of medical aid schemes that people can join. Some providers even offer group schemes, where people get cover through their place of employment.
Medical Aid Schemes are Failing
The premise of health schemes is that when a health crisis arises, members are covered for medical costs. So that they can focus on getting better and moving on with their lives.
Lately, medical aids are finding it quite hard to match health costs to the premiums they pay. This is because the law does not strictly regulate the medical industry. Health experts often charge way more than what schemes can afford to pay.
In the past medical aids have worked on the basis that health services had a standardised fee structure across certain facilities and treatments.
But, with the influx of private facilities and experts venturing into specialised medical procedures, standardisation and regulation have not been effective enough; such that each charges their own ‘fair value’ price for their services.
Most aid schemes have opted to pass on the bill to their clients through increasing the premiums and entering into trade agreements with certain service providers, for exclusivity and rate discounts.
The increase in premiums does not guarantee, however, that the scheme will cover medical fees in full.
Why get Over-insurance for Medical Cover
Gap cover guards members against poor health scheme pay-outs. It is a short-term insurance product that protects clients against these shortfalls. So that clients won’t end up paying huge sums for treatment they believed covered.
Gap cover is open to all members of a listed aid scheme in South Africa. It does not replace normal medical aid but functions as an add-on for extra protection. Further, there are many different providers to choose from.
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