When researching gap cover, you need to know what the terms described in your plan mean. Understanding terminology is, therefore, crucial.
Most people do not know what each term used to describe benefits mean.
Thus, reading through the jargon listed below will help you a lot when thinking about which gap cover plan will work best for your needs.
Understanding Terminology and Gap Cover Jargon
Tariff Shortfalls – Refer to the difference between the specialist’s rate and your scheme’s rate.
Sub-limits – Health schemes set limits on what they will cover for certain treatments. A sub-limit provided by your gap cover plan will ensure cover for the shortfall between what experts charge and your health scheme pay.
Co-payments – The excess amount payable up front to the hospital before any treatments can take place. This benefit can help you out in such cases.
Emergency Casualty Benefits –Covers fees for casualty wards in private hospitals. Most people don’t have the money for these costs at hand in case of an emergency. Thus, having this benefit will cover you in these instances.
Hospital Cash Benefits – Provide a cash benefit for every day spent in the hospital. The amount you get will depend on each gap cover provider and the number of days spent in the hospital. This serves as a great comfort bonus!
Premature Birth Coverage – Describes cover provided when a baby is born 34 weeks into pregnancy or earlier.
Death/Permanent Disability – The scheme pays out an amount per member who dies or becomes disabled and is no longer able to continue working.
Medical Scheme Premium Waiver– The benefit covers health scheme fees of a certain amount per month, per family member.
Dental Reconstruction – Provides for coverage of dental treatment in the event of trauma, cancers and tumours.
Deductibles–Are amounts payable by members upon admission to a hospital.
Understanding Terms Used by Insurance Providers
The above list is basic jargon used by all gap cover providers to describe their benefits. Each provider will offer different amounts which depend on the plan you choose.
Knowing what each term means is of great benefit to you. But even so, you will still need to talk to your gap cover broker to get a better idea of what their benefits include.
Consulting with various companies or making use of comparing websites will help you find the best one.
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