If you are thinking about buying gap cover, here we have an article that can help you decide and will explain to you what gap cover is.
What should I consider before I buy gap cover?
- Establish possible shortfalls in medical tariff pay-outs
- Buy gap cover to top-up the difference
- Low-level medical schemes=low-level pay-outs
- Get advice from an insurance broker
- Gap cover gives you peace of mind
There are four major questions to ask before you buy medical gap cover. With hospitals and medical service providers charging anything up to 500% or more above standard medical aid scheme rates. Gap cover has become essential. If you’re thinking about buying gap cover, you should first consider the following:
What is medical gap cover? – thinking about buying gap cover
Medical aid gap cover is an additional optional insurance policy that supplements your medical aid scheme and safeguards you from the responsibility of having to foot large and unexpected bills that your medical aid will not cover. In other words, it pays the difference between what your medical aid is prepared to pay and the amount from your medical practitioner. It also covers you for expensive, specialised treatments that may not be covered by your medical aid scheme.
What benefits does your medical aid scheme pay?
Before taking out gap cover, you are strongly advised to speak to your broker to establish exactly what is covered and what is excluded by your medical aid scheme. In other words, the lower the tier, the fewer benefits on offer. Monthly premiums are also pegged on a tier-basis. It stands to reason that members of medical schemes who have opted for a lower-tier rate will not enjoy the same benefits as a holder of a more expensive option and are also far less likely to qualify for the cover of specialised in-hospital procedures. Lower-tier medical scheme clients must opt for gap cover that will plug the shortfalls of his/her medical aid scheme.
What rates apply to your medical aid scheme? – thinking about buying gap cover
Medical aid schemes pay out between 100% to 300% of prescribed medical tariffs. Depending on the monthly premium tier-level you have selected. Don’t confuse that statement by assuming you will either be fully covered or have an excess payment due to you on the bill. fact, it is now more common than not for medical practitioners to charge 500% or more for services rendered. Leaving patients with the huge financial burden of having to cover those shortfalls out of their own pockets. That is why it is so important for you to ascertain exactly what benefits you will receive in the event of hospitalisation and to cover any shortfalls with a gap cover
How do you prepare for the unexpected?
No one expects to be diagnosed with a life-threatening illness but this happens on a daily basis so it is always best to be prepared. Medical aid schemes set pay-out limits on emergency surgical procedures, irrespective of the tier-level you have chosen. Check your medical aid tariff schedule and compare it to the current cost of specialist and hospital fees. Top-up that difference with a gap cover policy to protect you from any surprises.
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