A medical aid member gap cover plan takes care of added costs.
Whether you are in hospital for a routine procedure or something more serious, you want to focus on recovery when you leave.
You don’t want to have to delay your recovery by worrying about bills that you have to pay.
A few years ago, if you had a medical aid plan, this wouldn’t even have been an issue. Your medical aid would have automatically paid all your medical bills.
A medical aid member gap cover plan fills the gap
It might come as a shock, but your medical aid plan may not pay the entire bill. They have changed the way that they do things.
With rising medical costs and limited sources of income, medical aid firms have drawn the line.
They will no longer pay doctor’s accounts randomly. Check the fine print of your policy. All medical aid rules determine the base rate that they will pay.
If these are the rates doctors bill you, that’s fine. If the accounts exceed this amount, you pay the difference.
How much more could doctors charge anyway?
You would think that the base rate the medical aid firm sets would be in line with the market average. You would be wrong. They don’t look at market prices when determining what they will pay per procedure.
In fact, they look at the average amount that they have paid in the past. They then factor in how much money they have in the pool. This determines how much they pay out. And this means that these rates could be way below market average.
It’s usually not as much of a problem if you want to go to network hospitals. But what if you need more specialised care?
Specialists can charge a premium because of their expertise and they normally do. And this could be anywhere from double to quadruple the base rate.
Am I just trying to scare you?
No, I am trying to make you aware of a very real issue. You don’t want to learn about this the hard way.
So many South Africans have been saddled with crippling medical bills because they weren’t aware of this issue. You don’t want to be one of them.
As a medical aid member gap cover is vital
So what do I do? You could look at switching to a medical aid that offers better cover. But even this might not be enough. Even the best medical aids cap their payouts to a maximum of double the base rate. Switching to a better medical aid can also be expensive.
Gap cover is an alternative that is surprisingly affordable. The companies that offer gap cover can keep premiums lower because of the specialised nature of the cover.
Good plans start from less than R200 a month, and you choose the level of cover you like.
The plan is kept simple, and so are the rules for joining the scheme. To qualify for gap cover in the first place, you must be a member of a registered medical aid.
Gap cover also only applies if your medical aid pays a portion of the account and this also helps to keep premiums down.
If you don’t want a hospital stay to result in crippling debt, gap cover is the solution.
To get a FREE gap cover quote fill in the form on this page and submit it
All info was correct at time of publishing