What Medical Gap Cover Should I Buy?

What medical Gap Cover works for mePeople often wonder what medical Gap Cover will work best for them. There are so many gap cover policies offered that it is difficult to pinpoint any single product as the best.

They all offer benefits and have built-in co-payment and exclusion clauses. People looking to improve their medical health schemes should research all the options before choosing a gap cover policy to best fit their needs.

What Medical Gap Cover? Take a look at Stratum

There are dozens of short-term insurance companies in South Africa that offer gap cover. This makes it hard to decide what cover to buy. But let us take Stratum as an example.

One of their biggest charms is that Stratum’s Gap Cover includes co-payments, unlike many other companies that only offer this benefit as an extra.

Co-payments are the responsibility of medical aid members who, together with their medical schemes, pay towards the cost of hospital admissions and certain hospital procedures.

It also pays the members’ costs for outpatient CT and MRI scans and includes cancer cover up to an annual limit of R350 000 per policy.

However, to obtain Stratum Gap Cover, you must belong to one of these aid schemes:

  • Bestmed
  • Bonitas
  • Discovery
  • GEMS
  • Genesis
  • Hosmed
  • Medihelp

Other additional benefits

Stratum offers:

  • Membership up to the age of 70 years
  • R6 000 for in-hospital consumables
  • R12 0000 annually for in-hospital X-Rays
  • R5 000 accidental death cover for the main member and spouse
  • R5 000 in-hospital wisdom teeth removal per child yearly
  • Premium waiver benefit for six months

Like most other short-term insurance companies, Stratum also has exclusion clauses, such as one year for pre-existing medical conditions, a general three-month waiting period before the gap cover becomes effective and complete exclusion for pre-diagnosed cancer.

Why Gap Cover

Gap Cover has become a crucial part of people’s medical insurance.

Members of aid schemes are at risk of having to foot the bill for huge shortfalls when hospitalised.

Medical aid schemes state ceiling tariffs for different hospital procedures, but the surgeons, anaesthetists and other medical experts do not have to follow that pricing structure.

In fact, it has become common practice for experts to charge patients five times more than what their medical aids are willing to pay.

This leaves families in a dire financial crisis during times of illness.

Gap cover in South Africa will pay out the difference between medical scheme tariffs and medical experts costs.

Another big attraction is that gap cover is cheap and can be obtained from under R200 monthly.

It will cover the main member, his spouse or life partner and all their children but only if they are all members of the same scheme.

Gap cover can no longer be seen as a luxury.

It has become a crucial form of insurance to protect families from extra stress during times of illness.

Still wondering what medical gap cover to buy? Get your own custom quote! Just complete and send us the form on this page.

All info was correct at time of publishing