5 Reasons to Get Medical Gap Cover

December 10, 2021

Medical aids have built in limits when it comes to what they will and won’t pay. Now, on a day to day basis, this is annoying but manageable. You can plan for your expenses and work around it. But when large expenses arise, it’s a headache. Those are the reasons to get medical gap cover.

But what happens if you have a medical emergency? What if you need specialist medical advice or hospitalization in a hurry? And what if your medical aid won’t cover this in full?

What is Gap Cover?

Medical aid tariffs are set by your medical aid, and this is what they base their pay-outs on.  It is what they calculate that the medical procedures should cost.

If you have one of the better medical aids, they may pay as much as three times this rate.

Reasons to Get Medical Gap Cover in South Africa

Now, this may sound good until you take into account that the specialist/ doctor could charge four times this rate. So, even if you have the very best medical plan, you are still going to have to have out of pocket expenses. That’s one more of the many reasons to get medical gap cover.

Gap cover is short term insurance that will take care of the expenses that your medical aid does not pay for.

What is it Going to Cost Me?

The cost will depend on what level of cover you choose. Your immediate family is normally covered under the same premium.

The cover for some of the more comprehensive policies ranges from about R180 on a monthly basis. A poll of the five top companies shows an average rate of around R270 a month.

Before choosing a particular policy, it is a good idea to check what the cover entails. It might be tempting to choose the cheapest cover, but that is not always the best option.

Reasons to Get Medical Gap Cover

Let’s say, for example, you can choose Option A for R300 per month. You get 200% cover without dentistry benefits.

Now perhaps Option B is R400 pm. You get 300% cover, and dentistry is included.

When doing the comparison, that extra R100 a month might not seem worthwhile. But think for a moment if you have to make a claim.

What if you are in an accident? You are looking at costs for emergency surgery, diagnosis, the hospital stay, reconstructive surgery, etc. That could add up to thousands or even hundreds of thousands of Rands.

How much of that will be covered by your medical aid? How much would your gap cover pay out? See how choosing the cheaper option can cost you dearly in the long-term?

By now you should understand the reasons to get medical gap cover.

Making the Right Choice

It isn’t nice to think that one day you or one of those that you love might need emergency medical care. But avoiding the issue is not going to help you either.

There are a lot of gap cover plans on offer on the market today. So choosing the right one for you can be somewhat confusing.

That said, doing your research upfront will help you to make the right decision. But take the time and effort to understand what each company is offering. Compare the plans objectively and don’t make a knee-jerk decision made on cost, and you will make the right choice.

To get a FREE medical gap cover quote, please complete and send the form on this page

All info was correct at time of publishing