Gap cover is an essential insurance product that beefs up your medical cover when you need it most. Here are ten points about medical gap cover you should know.
As a medical aid member, you qualify for this essential cover without even knowing it.
Ten points about medical gap cover. What is Gap cover?
Your medical aid does not always pay 100% of your specialist or hospital account. If the amount is more than the standard medical aid rates, gap cover will pay the shortfall, not you. That’s what gap cover is.
What Gap cover is Not
It is not a replacement for your medical aid. In fact, if your medical aid rejects an entire claim for any reason than limits being exceeded, the gap cover claim is likely to be rejected as well.
Besides which, if you are not a member of a medical aid plan, you are not allowed to have gap cover.
Gap cover is also not a quick fix measure for when you have stepped over the rules of your medical aid plan. If penalties are imposed as a result of not following the rules properly, your gap cover will not pay them.
Gap cover is Straightforward
Most companies offer straightforward cover – a basic and a comprehensive plan. So, there are no endless choices about what cover to choose. You just have to consider a couple of different options.
Gap cover is Insurance, not Medical aid
Some companies that offer a medical aid plan, such as Liberty, are also licensed to sell other insurance, such as gap cover. You also have the option of choosing a specialised gap cover company like Turnberry, Stratum or Zestlife. Your gap cover policy can run completely independently of your medical aid.
You must Have a medical Aid plan
This is one restriction that there is no getting around. You must already have a medical aid plan to qualify. Your medical aid payments must be up to date when claiming, and you may be required to prove this is the case.
Gap cover is Affordable
You can find gap cover policies for as little as 10% of your medical aid premium per month for the whole family.
Gap cover and the National Health Insurance
The government is trying to set the stage for everyone to be a member of a state medical aid. As a result, it has been trying to change the law regarding gap cover, in the hopes of making it illegal.
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