Does Gap Cover Include Everything?

    Maybe you have heard something about gap cover. Perhaps a friend has told you about getting a massive medical bill  their medical aid would not pay. Or maybe you are wondering if you can get gap cover for pre-existing conditions.

    Not everyone has heard of gap cover. It covers any shortfall between what your medical aid pays and the amount that appears on the bill. And that can add up quickly. Admittedly, most medical aids will pay out 100% of standard medical aid rates. But very few specialists/ hospitals charge medical scheme tariffs.

    In some cases, you could be looking at a bill that is as much as four times more than what the standard medical aid rates are.

    Whatever the reason, you are now looking into getting gap cover yourself. It seems pretty simple except that you have had some health issues and wondering if you can get gap cover for pre-existing conditions. Perhaps you have to take some chronic medication; perhaps you simply have a pre-existing condition that is less severe.

    The problem is that you realize that these issues are going to get in the way of you getting full gap cover. Some companies will impose a waiting period of a year before covering pre-existing conditions. Other will make you wait even longer.

    Can One Get Gap Cover for Pre-existing Conditions?

    Gap Cover for Pre-Existing Conditions

    In the past, getting any cover at all for pre-existing conditions meant an extended waiting period or paying a much higher premium.

    Either that or there will be no cover for anything relating to the pre-existing condition.

    Let’s say, for example, you had gallstones. The insurance company could either refuse to pay out any claims related to gallstones for the first year or exclude any such claims in future.

    Zestlife to the Rescue

    That is where Zestlife differs from other gap covers.

    There are no exclusions based on pre-existing conditions at all.

    Meaning that if you need to go in for that emergency gallstone operation and there is a shortfall to pay, you will be covered.

    Another area where Zestlife differs from other gap covers is in the waiting periods. Now, obviously, for certain issues, they need to have some waiting period before cover kicks in. That just makes good fiscal sense.

    The waiting periods relate to the following conditions:

    • Cover starts after a ten-month waiting period before childbirth.
    • For the procedures listed hereafter, you will not have cover for the first six months and will enjoy half the full cover for the six months after that – spinal surgery, arthroscopic procedures, joint replacements, cataract surgery, nasal surgery, dentistry, hernia surgery, cardiac surgery, and hysterectomy.

    Should you be diagnosed with an issue after having taken out the policy or be involved in an accident, the full cover will be extended to you as long as you have paid your first premium.

    Any Age-Related Concerns?

    Also, unlike most other insurers, Zestlife does not have a cut-off age for cover. That means you can just as easily take a policy from them if you are in your twenties as you can if you are in your seventies.

    As long as you have medical aid, you can get gap cover from Zestlife.

    To get a FREE medical gap cover quote, please complete and send the form on this page