Medical Aid Shortfalls – Succesful, Reliable Cover

Medical aid shortfalls are something most South Africans have experienced at one point in their lives. Medical cover shortfalls arise when your insurance cover pays a portion of your medical bill, and you still owe your doctor some money.

With the cost of keeping yourself constantly on the rise, medical expenses in South Africa have been on the rise compared to the standard medical plan rates.

Besides, many people have undertaken a medical procedure with the thought that their health insurance will foot the entire bill, only to find that the medical scheme requires them to pay extra money for the shortfall.

However, the cause of your deficiency is not your medical aid plan; they just pay according to the current medical aid rates. As such, if your doctor charges above the standard rate, then you are liable to pay the excess money.

medical aid shortfalls

Here is the cure for Medical Aid shortfalls

Unexpected medical aid shortfalls can leave you seriously in debt

Evidently, this can come as a big shock to you, especially if the hospital admits you.


Hospital shortfalls can amass up to thousands of Rands very quickly.

And you cannot make a plea of inability to cover up for the piled up shortfall. As such, you have no alternative but to pay or you will find your credit report suffering.

Minimising the cost with Medical aid Shortfalls

In the event of a medical emergency, you do not have much choice on how your treatment goes. However, with routine procedures, you can have several options to explore to minimise the cost.

For instance, with pregnancy, you can conduct a research. This would give you a rough estimate of the cost you are likely to incur. One has the chance of negotiating a better deal with the specialist.

In many cases, making an upfront payment to the doctor can give you better-negotiating grounds as opposed to using insurance plans since the physician does not suffer the inconvenience if waiting.

Talk to you doctors, and let’s say you have a child, are you planning a natural birth or C-section, and what are the cost implications to both.

Medical Gap Cover for Medical Scheme Members


Find out what your medical aid pays

Depending on what your health scheme you might find you are covered at higher rates than the standard medical aid rates.

With some insurance providers paying twice or thrice the current rates, with such plans obviously being more expensive.

Additionally, it’s imperative to find the conditions attached to your policy when it comes to payment. Do you have visit specific hospitals or do have to get a pre-authorization?

Always find out the what the medical aid pays and what they will not settle. By doing this you will save yourself lots of inconveniences.

Gap cover for medical aid shortfalls

Gap cover gives you peace if and can help with rising medical expenses. What happens is that your gap cover starts when your medical cover have played their part. Although the gap cover has limits, they provide the much-needed support in case of a shortfall.

For a FREE gap cover quote simply enter your details into the form provided and click the GET A QUOTE button!

All info was correct at time of publishing