Strong Case for Medical Gap Cover in South Africa

November 24, 2024

The case for medical gap cover in South Africa has never been stronger than it is now. That is because the medical schemes are paying less and less of your medical expenses, leaving you to pick up the shortfall.

In particular, the medical schemes are paying less and less for hospital stays, specialists, anaesthetists and expensive top-of-the-range treatment, such as for cancer.

Wouldn’t it be great to “insure the gap” so that you never have to run out of medical savings or pick up a medical tab again? Good news: now you can do just that.

Good news: now you can do just that.

Strong Case for Medical Gap Cover – A South African Invention

South Africa’s medical schemes are unique and so are the problems that members encounter.

Here’s the biggest problem: medical aids don’t cover as much as you think they will. It sounds great when your medical scheme documentation says the scheme will pay 100%, 200% or 300% of your expenses.

But 100% of what? 200% of what? 300% of what.

Not your medical bills, that’s for sure

Instead, your medical aid promises to pay 100%, etc. of National Health Reference Price List and Medical Scheme Rates (NHRPL & MSR Rates). That is a list of guide prices that most medical aids use.

So say for instance your medical aid pays 100% of your expenses. And say the list price for a consultation with an ear nose and throat specialist is R1000. But the actual bill that arrives is for R2000.  And who picks up the tab for the extra R1000? You do!

Unless you have medical gap cover, that is. And therein lies the answer to why you should get gap cover.

Cheap at the Price

You would expect medical gap cover to be expensive, but it is not. For instance, I, my husband and my daughter are covered in full for less than R500 a month with Zestlife. And they did not require us to have medical examinations either when we signed up.

So if you are a member of a South African medical aid, there is a clear case for medical gap cover. Sign up now!

Just add your contact details to the form on this page to get your personal medical gap cover quote

All info was correct at time of publishing