Medical Aid Gap Insurance – Price Conflicts Ongoing

Maybe you hold the opinion that gap cover is an added expense for just another policy. The top ten reasons to get medical gap insurance should convince you otherwise.

Unfortunately, lots of folk believe that 100% cover espoused by their medical scheme plan is the end of the story. Unfortunately, it’s only the beginning.

A clear, instructive point by point list explains why you need a backup plan; this is not just another policy. It’s “Plan A.”

Top Ten Reasons to get Medical Gap Insurance

Top ten reasons to get medical gap insurance1. What do medical schemes mean by 100%?

To you one hundred percent may mean “totally” or “completely”.  But, no, medical schemes are not lying when they say they cover procedures or other expenses.

They are referring to 100% of the established, pre-determined standard medical aid rates.

So should a specialist or hospital charge in excess of that rate, the medical aid will pay its portion only. It is up to the patient to pay the shortfall.

2. Medical aids say standard medical aid tariffs are high enough

Obviously there is major conflict between the actual cost of medical care and the amount that medical aids will pay out. Admittedly, if specialists and hospitals charged only the standard rates they would soon be out of business.

3. Specialists and hospitals can charge what they like

Never forget that hospitals and specialists are business people as well as healthcare providers. They have expenses to pay and have to make profits. What is more, they are free to charge what they like. If their reputations are good they can charge more. Which they do, as we all know.

4. 500% mark-ups are more common than you think

Did you know that some healthcare providers charge up to five hundred percent more than the standard rates? No wonder being sick can cost you a fortune.

5. Being ill can make your bank account sick too

Obviously everyone wants the best healthcare. No one wants to land up in a state hospital, where you might wait days to get attention. The best costs more, no doubt about it.

6. Unlikely that your savings will be enough

Bypass surgery, to take an example, can run into the hundreds of thousands of rands. And unless you have comprehensive medical aid (which costs a fortune each month) you will probably have to sell your house to pay the excess

For instance: if you medical scheme paid R100 000, you would have to come up with to half a million rand to cover the rest of the bill. How long will it take you to save that much money? You’re right: it’s really no feasible.

7. Saving are really for other purposes

Savings should not be used for medical care. They can be used for all the other expenses that would mount if you were to end up in hospital for an expensive operation — items such as recuperation, groceries and school fees.

8. The bugbear of medical aid limits

Towards the end of the year, most people find their medical aid savings accounts running dry. And even the best hospital plans or medical plans have hospital stay limits. And what if you need chemo, for instance? The pot will quickly empty.

 9. The beauty of gap cover

The benefit of gap cover from Zestlife is that it pays all those expenses that you would otherwise have had to pay out of your own pocket – the dreaded medical aid shortfall. You can dedicate your funds and energies to recovering rather than worrying about healthcare bills.

10. Is gap cover cheap?

Yes, it is. What is more, a single top up policy includes everyone who is on you medical aid, including spouse, children etc.

Convinced by the top ten reasons to get medical gap insurance? Get a quote here by completing and submitting the form on this page.
Medical aid members only.

All info was correct at time of publishing