Here is a true story from a visitor to our website about how her gap cover policy helped to pay for a maxillo-facial procedure for her daughter:
“My daughter’s braces came off and the orthodontist advised us that she would have to have her wisdom teeth removed as x-rays showed that there was no space in her mouth for them to come through, and they would push the newly aligned teeth skew again.
“The oral maxillo-facial surgeon we saw made an appointment for the procedure to take place under general anaesthetic in hospital as the roots were impacted and it’s not a straight forward dental extraction.
“On arriving at the hospital at 6.30am to fill in the admission forms, I was informed by the hospital that there was a c
o-payment admission fee of R5650, not covered by my medical aid.
“On phoning my medical aid to query this, they informed me that the co-payment was in place because too many members were admitted to hospitals for simple procedures like x-rays, to have these covered by in-hospital funds, thereby saving their medical aid savings.
“Because of this fraudulent behaviour, they now refused to pay the full hospital fees for dental procedures taking place in hospitals.
“I paid the R5650 by credit card.
GAP cover to the rescue for maxillo-facial costs
“The oral maxillo-facial surgeon suggested we submit a claim for this shortfall to our GAP cover provider. After submitting all the paperwork – statements, accounts and invoices from the surgeon and the hospital, I was refunded the R5650 in full within two weeks.
“GAP cover for our family costs us just R375 per month, and it’s a lifesaver for medical aid shortfall emergencies!”
Moral of the story: Medical aid members should have gap cover. Complete and submit the form on this page to get a quote.
