Liberty gap cover costs take in to account the fact that doctors, specialists and hospitals all work to their rates?
Your medical aid plan works to a different rate, a standard medical aid rate. This means there is often a shortfall between the two billed amounts.
If your bill is more than the standard rate, healthcare won’t pay for the excess, and you will have to.
That is where Liberty gap cover comes in to help save you financially, and we are talking about serious money.
Liberty gap cover
Gap cover takes care of the gap between what your medical aid will pay and what the specialists charge. With gap cover, you’ve got many choices.
There are two options from Liberty in 2019. Plans range from R274 to R521 per month depending on the variables you choose.
Both options are available to members and dependents of all South African registered medical schemes.
Liberty Gap Cover has no age limit for entry and no restrictions on the number on how many children you can cover.
Liberty Gap Cover offers 500% of Medical Scheme Tariff cover for in-hospital procedures.
The Dentistry Extender. If chosen, meets your needs as it covers certain dental procedures that may not necessarily be covered by your medical scheme.
Liberty Universal Gap Cover enhancements in 2019:
- 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 to R7 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.
The Liberty Medical Gap Cover product meets the needs of members of medical schemes who don’t cover the total medical practitioner costs when you are in a hospital.
Gap cover from Liberty is recommended as a solution to disillusioned medical aid members as it covers the difference between the medical practitioner’s charges – limited to 5x the medical scheme tariff.
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All info was correct at time of publishing