6 Ways Your Medical Aid Falls Short

December 18, 2021

There are 6 ways your medical aid plan does not come up to expectation. In all cases the solution is to strengthen your medical scheme membership by signing up for gap cover.

6 ways your medical aid disappoints

  1. You run out of savings before the year is done. Having a savings account linked to your medical scheme option sounds great. But with the rise in medical costs of all kinds – hospital, specialists, GPs, medication, dental care – your savings can’t possibly keep up with your day-to-day medical expenses.
  2. Expensive shortfalls when you go to hospital or need specialist care. Just about everyone on a medical aid has experienced co-payments. South Africans learn the hard way that your medical aid generally will not pay the whole medical bill. Instead they pay a portion of it, according to what appears on their internal list of costs. So if a procedure costs R25 000 but only R12 000 appears on their list, you will have to pay the remaining R13 000 out of your own pocket.
  3. 6 Ways Your Medical Aid Disappoints You and How Gap Cover Solves the ProblemNo flexibility from your medical aid. The administrators of medical schemes go by the book. There is no channel to appeal, unless you knock on the door of the Council for Medical Schemes and go through a long and arduous dispute and arbitration process.
  4. Medical aid is hard to understand. The medical scheme administrators hold all the cards. There are dozens of medical schemes, and literally hundreds of options. It is a rare medical aid member who understands everything about any one plan. You are working in the dark most of the time, depending on your healthcare providers and the medical aid to sort out problems.
  5. Being on a medical aid skews the costs of all healthcare items. Put simply, when a healthcare provider discovers that you are on a medical aid, prices shoot through the roof. Human nature dictates this phenomenon. So while you have medical aid, you might actually be paying an extreme price behind the scenes.
  6. Medical scheme membership gets more and more expensive.  Medical aids have all the motivation in the world to recommend more expensive options and add-ons. Premiums never go down.

Having gap cover does away with all these problems. Stick to your current medical aid, but super-charge it with gap cover. You will experience a lightening of medical costs for a low monthly premium

Use the form on this page to request your gap cover quote.
It’s simple, fast and professional.


All info was correct at time of publishing