Definition of Gap Cover Copayments in South Africa

December 18, 2021

Modern medical aid policies attempt to be as flexible, affordable and comprehensive as possible. However, in the current global economic climate, it is impossible to predict all possible future requirements. Where in some cases you might need special treatment or a lengthy stay in a hospital. A member’s medical aid will not cover all medical bills for the treatment they have received. Continue reading to know more about gap cover copayments.



Understanding Gap Cover Copayments

gap cover copaymentsIn these cases, a copayment fee is usually compulsory. This is the difference between the service provider’s final rates and what is covered by the medical scheme. The copayment can become quite high, depending on the medical services and facilities required for treatment.  It will then come as a shock to the members,  realising the limitations of their medical aid. In many cases, the member does not have sufficient money available to pay these fees immediately. The possibility of this kind of situation has led to the creation of medical gap cover. This policy will give members peace of mind because the gap policy will pay for the medical aid shortcomings.


Choosing the Correct Medical Cover – Gap cover copayments

Choosing the correct medical cover is crucial. Because of this, you should carefully decide on your choice of medical aid. Before you choose which medical plan is best for you, you have to identify your needs. To ensure they know what you will receive, how much it will cost, and what possible shortfalls they can expect. While the monthly premium will obviously be the deciding factor in many of these decisions, this must be balanced by an understanding of the benefits and shortcomings that the particular policy offers. Important aspects will be a familiarity with copayments and deductibles that the cover will allow.  In effect, what the policy will and will not pay for.

Avoid the hidden costs

Nobody likes the thought of hidden costs, unexpected expenses, or the threat of unpaid bills. To avoid the stress and financial burdens that these situations can create, we recommend that anyone looking for the best option does their own extensive research on the subject, as well as asking for professional assistance.

Independent research is of vital importance to the member, as this is your only way of understanding what you are actually receiving in a medical aid package. There are some professional terms and jargon that could well mislead any person who is unfamiliar with them, but by putting in the time and effort to learn and understand them, they can make an informed decision as to whether a medical scheme is offering value for money or not.

Consider getting professional advice – Gap cover copayments

We firmly recommend getting help from a Broker. Brokers are familiar with the different policies available, while also assisting you to get the best plan. With forethought, sound advice and sensible decisions, the choice of a right gap cover provider will ultimately ensure peace of mind and long-term savings for the wise member.

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All info was correct at time of publishing