Medical shortfall cover in South Africa

Medical shortfall cover in South Africa is becoming an absolute necessity for most South Africans.

Despite their medical aid cover, consumers face unexpected medical bills that can have crippling financial impacts on family budget constraints.

What can medical Shortfall cover in South Africa do for Me?

  • Do medical aid plans, in general, provide sufficient cover every year?
  • Do medical aid plans fully cover the costs of hospitalisation?

If the answer to either of these questions is no, then Gap Cover, is the obvious solution.

What does gap cover, cover?

Gap Cover relieves the financial stress of facing unforeseen additional costs in times of illness. Medical aid schemes have a prescribed list of tariffs applicable to various hospital procedures, but these charges seldom cover fees imposed by members of the medical profession.

Private healthcare can get expensive

Medical shortfall cover in South AfricaPrivate sector medical professionals do not have to adhere to medical scheme tariff rates. Their fees can be up to five times more than what a medical scheme is going to pay.

This leaves the medical aid member with the headache of having to find the funds to cover the difference in costs.

Instead of applying for a loan and running the risk of getting deeper into debt, Gap Cover will ensure that policyholder is covered for these crippling additional costs.

Examples of out-of-pocket shortfalls

  • Coronary Bypass – R27 164
  • Caesarian Section – R8 413
  • Appendectomy – R2 053

What is Medical Shortfall Cover in South Africa

Gap Cover is a form of short-term insurance that pays up to 500% more than medical schemes for various hospital procedures.

It is affordable to most medical aid members, with monthly premiums starting at around R200, providing cover not only for the principal but also his spouse or life partner and children.

Gap Cover can be used in conjunction with any medical scheme, even when the holder changes from one company to another. Any member of a registered medical scheme qualifies for Gap Cover.

Waiting periods for Medical shortfall cover

  • Three months after joining and 12 months for pre-existing medical conditions
  • Claims must also be lodged within six months

Other plus factors

  • For an additional premium, Gap Cover can include Co-Payments for hospital admissions and CT and MRI scans
  • For an additional premium, Gap Cover is available for specified cancer treatments and specialised dentistry required after accidental injury

Fill in and submit the form on this page to get your one FREE gap cover quote – if you belong to one of these medical aids

All info was correct at time of publishing