Three Things to Consider When Choosing Gap Cover

December 4, 2024

The most important role that medical gap cover plays is protecting medical aid members from all additional and unbudgeted costs. This could be during doctor’s appointments, hospital stays, treatments and surgeries. The design is to cover the differences between your medical aid tariff and the tariff and private rates. Like with medical aid schemes, there are tonnes of different gap cover plans available to choose from. Before deciding to get gap cover and deciding which plan to choose. There are a few things that you need to consider when choosing gap cover.

Consider Where the Gaps Are When Choosing Gap cover

More than often people believe that by choosing a full medical aid option. All expenses associated with their hospital and related treatments are covered. This, however, is not the case. Even though your medical aid scheme claims to give full coverage. A lot of medical expenses are not cover by them. When wanting to choose a gap cover provider and plan. You need to thoroughly study your medical aid plans in depth to identify all gaps present in it. After identifying these gaps, you’ll be able to choose a gap cover plan that does exactly what the name says – it will fill the gaps found in your medical scheme plan.

Consider Medical Rates When Choosing Gap Cover

In South Africa – and most other places in the world – private healthcare providers and specialists are free to charge whatever fee they find fit for the specific medical care that they provide. Do research regarding the medical rates of private institutions and healthcare providers. These rates can sometimes be 300% to even 500% more than what your chosen medical scheme provider allocates for treatments. If this is the case, you need to look for medical gap cover providers who will be able to fill the gap left between what your medical scheme insures and what your chosen healthcare providers, specialists and surgeons charge.

Consider Your Finances

Considering your financial stand plays a big role in the deciding whether you should invest in medical gap cover or not. Most people put extra money away for emergency situations. If you do, you need to consider whether these savings will be enough to cover the biggest medical bills in the event of being diagnosed with a rare illness or the costs of being involved in a serious accident. If you do not have any savings, you need to think about whether your monthly budget will be able to accommodate this. Also, consider whether taking out a loan for these expenses will be possible for you. If none of these options sounds any good to you, getting gap cover might be your only other option. Just make sure to choose a coverage plan that will be affordable for you.

After considering these three important things, your choice regarding gap cover will be much easier. You will be able to decide if gap cover is the boost that your medical aid scheme needs and what plan will fit your specific needs the best.

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All info was correct at time of publishing