Complimed Medical Shortfall Cover Explained
December 14, 2016
Complimed medical shortfall cover could provide the solution for clients whose medical schemes do not offer comprehensive Medical Savings Accounts.
Gap Cover ensures payment of unexpected additional medical costs such as specialist fees, blood tests and hospital treatments.
So for a small monthly premium, Complimed medical shortfall cover pays the difference between the final amount charged by experts for hospital services and the fees covered by medical schemes.
While Gap policies from other companies may only pay market rates and specific amounts charged by professionals, Complimed offers full protection but requires members to either use medical practitioners registered with the enterprise or to persuade their doctors to register with the scheme.
Complimed medical shortfall cover Products and costs:
Gap SUPREME: PREMIUM – R320 pm – full range of gap cover
Gap PREMIUM – R200 pm
And Gap SELECT: PREMIUM – R300 pm
Listed Procedure Advance: PREMIUM – R210 pm
For full details download the brochure at:
Another great innovation by Complimed is its GAP Plus for Seniors of 71 and above.
So for R350 per family per month, it provides additional cover for in-hospital specialist charges. And also enhanced protection to a maximum of 500 percent over-prescribed medical scheme tariff limits.
The cover limits to R2 million per family annually and Co-Payment Cover to R50 000 per family annually.
It pays for outpatient procedures as listed in policy documents, including chemotherapy and radiotherapy, kidney dialysis and MRI and CT scans at recognised network hospitals.
It also includes costs incurred for emergency treatment in hospital casualty units not met by medical schemes but is limited to R7 500 per family each year. (Certain restrictions apply as contained in the policy document).
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All info was correct at time of publishing