Why Have Medical Gap Cover at All?

Many people ask “why have Medical Gap Cover?”. They take out medical aid and assume they are covered for any medical situation that might arise. They assume the medical aid will cover hospital bills, specialists and all medical expenses. That is the whole point of a medical aid surely. Why then would anyone have additional gap cover if they have medical aid?Why have medical Gap Cover?

Most people gloss over the details about what their medical aid covers. They then get a rude awakening after a stay in the hospital, when they suddenly receive numerous medical bills they thought were all covered by their medical aid.

So Why Have Medical Gap Cover?

Gap cover will bridge the financial gap between what hospital and doctors charge, and the amount medical aids pay out.

That is the very reason for its existence. You might well wonder, what is gap cover? Or Why have medical Gap Cover?

Medical aids all have limits and will pay according to their tariff schedule. Many people are not aware that doctors, specialists and hospitals charge rates at their discretion, often at a significantly higher rate than medical aids provide for. This, the difference between the charges and the medical aid payouts is where the gap, or shortfall, arises.

Why Medical Gap Cover Is Needed

Gap cover will remove financial stress. You will know that the shortfall will be provided for. If you are currently on a medical aid plan, you can request a free medical gap cover quote. Also, if your immediate family members are on the same medical aid, the quote will cover them as well. If you accept the quote, you will pay the additional monthly premium, over and above your medical aid contribution, and you will have the necessary gap cover.


What are Gap Cover Premiums


Gap cover will allow you to have peace of mind

With gap cover, there will be no unexpected financial burden after a visit to the hospital, that will leave you cash-strapped and unable to cover the bills. This is the answer to the question “Why have medical Gap Cover at all?”.

The majority of gap cover plans available will pay 400 to 500% of the medical scheme rates. Some plans pay as much as 600%. Many gap cover products have additional benefits, including co-payment cover as well as cover for accidents. You need to do your homework to decide which plan will be the most suitable for you and your family’s circumstances.

Gap cover provides for the shortfalls

If you are still questioning the value of gap cover, let’s look at an example. You suddenly have to rush to the hospital because of a medical emergency or procedure, you might have to consult with specialists, have surgery, use an anaesthetist and many other expenses. There will also be costs for medication.

You are on a medical aid that you know provides for 100% of your hospital costs. The problem arises when the various charges are way more than the 100%. They could be a lot more than 100%, even exceeding 400% of the medical aid rate. If you were not aware of this and wonder who will pay the difference, the reality is that you will be responsible for these expenses. Now, you will wish you had taken gap cover.

Does it make sense now?

The company providing the gap cover will pay your claim into your bank account. That way you will have the money necessary to cover all the additional expenses.

There are so many concerns and fears in this uncertain age we live in, do not let your health be one of them. The last thing you want to worry about when you or a loved one is in the hospital is the extra expense. The last thing you want to face when you come out of the hospital is a pile of unpaid bills.

Gap cover is extremely affordable, starting from as little as R 90 a month for a whole family. You can not afford not to have gap cover.

To request quote for medical gap cover, please submit your details on the form you see on this page.


All info was correct at time of publishing