Gap Cover for Medimed Medical Aid

December 14, 2021

Medimed Medical Scheme is a medical aid that offers its members benefits that they can buy. This requires that the medical scheme pays for the medical costs of the member according to the plan that the member selected. Here we will have a look at gap cover for Medimed medical aid.

Just like with other medical schemes, Medimed won’t be paying for all your treatments – those above the standard medical scheme tariff guide.  Gap cover for Medimed Medical Aid members is available to pay for the amounts the medical scheme won’t pay.

Gap Cover for Medimed Medical AidGap cover is the difference in the amount that you were charged to be in a hospital for instance, and what your medical aid will pay. In most instances, private hospitals and specialists will charge you more than what your medical aid will cover. And that’s what is known as gap cover. Instead of you paying the excess amount, gap cover will.

The rate the medical aid schemes pay for when you are in a hospital and the rate the service providers charge are worlds apart. Medical aids charge at medical scheme approved tariffs. But your medical service provider will often charge much more for their services. That huge difference is what you will be responsible for.

The Implications

When you receive your in-hospital account. You’ll notice the prices of procedures done are 2 or 3x more than what your medical aid scheme pays. There are many people who aren’t aware of this. They believe they have the full cover by their medical aid because after all, it said 100%. Frightening financial predicaments is what many people find themselves in.

There’s a Solution

Medimed offers gap cover from  Complimed – not a medical scheme but an insurance product. Gap cover is for procedures that take place in a hospital. Complimed will fill in the gap by your doctors and what your medical aid will pay.

Actual benefits paid are subject to a maximum of 300% of the scheme tariffs, according to the policy. Even though your doctor does charge more than this, you are still responsible for covering the additional amounts yourself. That is why it is important these days for you to discuss the best rates with your specialist to avoid nasty surprises.

Get Gap Cover for Medimed Medical Aid

If you’re a medical aid member, you need gap cover. You can apply by completing the Complimed application forms online and then faxing it to PROVIDENCE (041) 395 4590.  Every month, they will collect the R75 from you via a debit order and then pay it over to Complimed for you.

PROVIDENCE also assists you in the claiming process once you have been in a hospital. To find out more about gap cover call the Medimed Customer Care group at (041) 395 4474, at least for peace of mind.


To get a FREE gap cover quote, complete the form on this page.

All info was correct at time of publishing