Do I Need Gap Cover?

December 9, 2021

“Do I need gap cover” you should ask yourself if your medical aid failed to pay for the entire bill while you were in hospital…after all you pay a fortune each month for medical aid?

Every South African with a medical aid believes they have 100% for medical treatment costs.

In your dreams. Medical aids have a lot of small print and don’t simply cover you completely when you are in hospital.

The day you leave hospital and receive your bill is such a shock you may find yourself back in hospital with heart failure. The bills will just keep pouring in.

Now you can apply for one FREE medical gap cover quote immediately.
Just complete and send the form on this page. Medical aid members only

Do I Need Gap CoverDo I Need Gap Cover – Shortcomings of Medical Schemes

In a country such as South Africa, most of the medical aid schemes come with different options that you can choose from. Just read about what the different options offer because they vary in their benefits and their costs.

Specialists’ Fees Can Kill

With a medical aid, you will notice that the professional services of your surgeon or your anaesthetist for instance are not regulated. They can charge their patients what they like, charging you sometimes well over that 100% that your medical aid was referring to and are willing to pay. So you have to pay the amount over that 100%, and this can sometimes be as much as 500% of your scheme’s rate. Who pays this shortfall? Yes, you have to pay the shortfall on your specialist’s account.

As an example…

Say for instance you have a caesarean section under your 100% cover from your medical aid scheme. Your scheme’s rate will at 100%, pay R2759.00 and your gynaecologist’s rate is R8833.00. This means that the shortfall of R6074.00 will need to be paid by you. This is where you must look at what is known as gap cover. The insurance company will be the ones covering this nightmare amount that you would have to find from somewhere.

What is Gap Cover?

Shortfall insurance isn’t part of your medical scheme membership – in fact, it falls under the short-term insurance act. You submit your gap cover claim after your medical aid scheme has paid the service providers. Even if you change your medical aid, you will keep your cover.

You Need It

When you decide on your medical aid option, it is advisable to take additional gap cover. Heaps of South Africans are reeling at the medical bills they are having to deal with because they believed their medical aid took care of all their expenses. Today, there is a definite place in the market for gap cover. You certainly do need gap insurance as without it, you’ll have to be earning a gigantic salary to cope with all the medical bills coming your way.

Speak to a qualified financial consultant who has the accreditation to give advice on your special set of circumstances regarding gap cover so that you don’t have to foot the best part of your medical bills.

Now you can apply for one personal medical gap cover quote immediately. Just complete and send the form on this page. Medical aid members only

All info was correct at time of publishing