Medical Shortfall Insurance for Sizwe Medical Aid Members

Sizwe started out in 1978, and as a medical aid, their focus has been to provide affordable medical aid for all South Africans. Further, medical shortfall insurance for sizwe members is also available.
They’ve got plans which cater for people on tight budgets, trying to make good health care available to everyone who would normally not be able to afford medical aid.

They’ve also got plans for companies, from ordinary employees to top-earning executives.

What attracts people to Sizwe Medical Aid is that they believe that medical aid schemes shouldn’t be complicated. They’ve tried to make their products easy to understand and use.  For more information on Sizwe, you can call their Call Centre on 0860 100 871.

Your High Premium DOESN’T Cover Everything

They list several plans with their medical aid options – from their basic hospital plan to their comprehensive medical aid. By doing some research, you will be able to choose a Sizwe medical aid options that will suit you as an individual, a family or a company. They offer their free Chronic Medicine Programme in some of their medical aid options including HIV/Aids- and chronic medicine benefits.

Medical Shortfall Insurance for SizweSizwe’s Hospital Care Plan’s premium for  2017 is R1,700 while their full plan has a premium of R4,885.  Their entry-level option, Gomomo Care provides value for money, and doctors are available through their selected network provider.
With Sizwe’s comprehensive medical cover, which is R4, 885, there are still going to be times when Sizwe doesn’t pay for your medical bills.

There will be a shortfall or gap between what they are prepared to pay and what the specialist charges. The specialists charge way over the standard medical scheme tariff rates, and this is what is causing the problems – the medical aids won’t pay, and the medical aid members can’t pay.

It’s these gaps in the cover which have meant Sizwe medical aid members have to buy gap cover. These extra costs catch members off-guard because they believed Sizwe would cover their hospitalisation and in-hospital expenses.

 

One Plan comes with its own Gap Cover

Sizwe offers gap cover, available to those on the Full Budget Plan. Also, they will pay up to 3x the standard Sizwe rate. Sizwe Full Budget gap cover applies to the cost of surgical procedures while in-hospital, covering to a maximum of 200% of the Sizwe rate. This isn’t just an automatic add-on for Full Budget Plan members. Members must apply for this.

Sizwe medical aid members are free to buy gap cover from any other providers in South Africa. Just some of these insurance providers are Ambledown, Turnberry, Zestlife and Stratum. But always remember to check with your doctor first about what their rates are. So that you can find out exactly what Sizwe will pay.

You need Medical Shortfall insurance for Sizwe

Indeed, going to the hospital is always stressful, but not having provisions make it far more so. Which is why medical shortfall insurance for sizwe members is so crucial.

If you’re in the hospital for weeks, your medical bills can add up to thousands upon thousands of Rands. Without gap cover, how on earth do you plan on paying these bills?

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All info was correct at time of publishing