Life is unpredictable. You might be healthy today and find yourself in need of medical treatment tomorrow. Medical treatment can be lengthy and costly, depending on the seriousness of your condition. Accidents happen in the blink of an eye and illness never asks permission from nobody. Medical expenses can cripple you financially even if you have a medical scheme in place. So what are medical gap cover policies?
A Gap Cover policy is a short-term insurance product that helps you bridge the difference in the amount charged by a Medical service provider. And also the rate that your Medical scheme are willing to pay for treatment received while in the hospital. It is not a Medical scheme. But an addition to your existing medical aid to cover shortfalls.
A shortfall frequently occurs between what a medical aid pays and the definite rate of a procedure or treatment. You will be held responsible for that shortfall. Gap cover policies are designed to compromise for that difference so that you don’t have to empty your savings account to pay providers.
What are Medical Gap Cover Policies – Options
Medical schemes have different options of coverage. And even in the event of having 100% cover, you might have to pay a huge amount for medical expenses. Much South African believe having a medical aid in place is coverage enough. And are surprised when they find out that specialists charge much more than what their medical aid are prepared to pay. Gap cover makes healthcare affordable and helps you get through those expenses.
Specialists are free to set their tariffs, and therefore they can charge you 500% more than what your medical aid will cover, which will leave you with an immense 400% to pay. There usually is a shortfall after your medical aid paid your service provider.
Waiting Periods and Limitations
They impose a waiting period before any claims can be submitted and it will be sensible to familiarise yourself with the limitations and exclusions before investing in Gap Cover.
General rules are not being older than 60 years when you apply, three-month waiting period after acceptance and a twelve month waiting period on pregnancy-related conditions.
Gap Cover pays you directly, and you are liable to pay your services providers.
This insurance is additional protection for medical aid members against the burden of financial stress. The cost of medical procedures is rising every day. As a responsible family member, the medical cover is your duty. You can gain more information on Gap policies by speaking to a financial advisor at any of the established Medical Scheme providers in South Africa.
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All info was correct at time of publishing