What medical shortfall products does Stratum Benefits company provide?
- Gap Cover 200 – to cover individuals and, if applicable, their families
- Gap Cover 500 – to cover individuals and, if applicable, their families
- Employer Range – Offered to companies that wish to get their employees aboard
- Slightly different in that it will cover you and your spouse under one policy, even if you have two separate medical aids
- If you are 65 or over, you will apply to be a policyholder. You cannot piggyback on your spouse’s policy in this instance
Statum Benefits offers a total of six different gap cover options when it comes to individual cover. Each policy has its pluses and minuses and to examine each in detail is beyond the scope of this article.
What we will do instead is to choose between the Base option and the Elite option so that you have more of an idea of the 
Stratum Benefits Company – Base Option
This is an affordable way to safeguard yourself in the instances where your medical aid lets you down. The benefit will pay the portion of fees not paid by the medical scheme.
The Base covers you as follows:
- For in-hospital transactions and some out-of-hospital transactions
- You do have Prescribed Medical Benefit cover on this plan
- Doctors and specialists bills
- Statum will cover shortfalls of up to 500%
- Dentistry subject to annual limit of R3 000 for the family for the year
- Radiology benefits are subject to an annual limit of R2 000 for the family for the year
- Pathology
- Physiotherapy
- Medication, in certain circumstances
Overall Limits
There is an overall limit of R150 000 for each person listed on the policy per annum. It should be noted that there are also sub-limits that might come into play.
Stratum Benefits Company – Elite Option
This is designed to offer the ultimate, comprehensive cover.
The Elite covers you as follows:
- In-hospital procedures and where treatment has occurred in a registered health practitioner’s rooms, for specific procedures. These must be payable from your major medical benefit, not your savings account to qualify.
- You do have Prescribed Medical Benefit cover.
- Doctors and specialists bills
- Statum will cover shortfalls of up to 500%
- Dentistry subject to annual limit
- Radiology benefits are subject to an annual limit
- Pathology
- Physiotherapy
- Medication, in certain circumstances
- Co-payment cover, whether a set amount or charged as a percentage. You have a once-off annual benefit for when you visit a clinic or hospital outside of the preferred provider network.
