Get a Zestlife Quote on This Page

    December 4, 2018

    How can I get a Zestlife quote?

    • You must be a medical aid member
    • You want to avoid a medical shortfall nightmare
    • Get a gap cover quote on this page
    • Pay affordable premiums to Zestlife
    • There are also optional extras for cancer and dentistry

     

    One of the biggest nightmares facing South Africans who have medical aid cover is the shortfall they have to pay themselves for hospital treatments.

    So many unsuspecting medical aid members believe they are covered for 100% of the cost of hospitalisation.

    After all, that is what is stated on their medical aid policies.

    What they do not know is that medical schemes work according to a set tariff rate.

    Members of the medical profession, on the other hand, are under NO OBLIGATION to stick to those rates.

    In fact, it is now common practice for the medical profession to charge patients up to 500% MORE than the tariff paid by their medical schemes.

    Get A Zestlife QuoteWho is responsible for payment?

    The policyholder is responsible for paying in the difference between what their medical schemes allow and what medical professionals and hospital charge.

    So this can have huge financial impacts on cash-strapped families.

    Zestlife’s enhanced benefits for Universal Gap Cover 2019

    • Overall regulatory maximum for medical expense shortfall cover increased from R150 000 to R160 000.
    • Cancer lump sum increased from R25 000 to R30 000.
    • Casualty benefit increased from R10 000 to R20 000. Casualty visit must be within 48 hours of the accident.
    • Medical Aid and Gap Cover Premium Waiver maximum increased from R6 500 toR7 300.
    • Medical Aid and Gap Cover Premium Waiver limited to accidental only, but the payment period increased from 3 to 12 months. This change was due to legal requirements.
    • Accidental dentistry maximum increased from R15 750 to R19 250 and amount per tooth increased from R2 250 to R2 750.
    • Non-Designated Service Provider co-payment increased from R8 600 to R9 300.
    • Oncology co-payment maximum increased from 20% to 25%.
    • Cover for robotic procedures up to R30 000.
    • Cover for procedures in day clinics.
    • New Oncology Benefit to cover 20% of treatment cost when oncology limit is exceeded.
    • Varicose veins have been added as an out-of-hospital procedure that is covered.

    Zestlife’s solution – Get a Zestlife quote

    Zestlife has the solution in the form of Gap Cover.

    Clients have the choice of two policies:

    The Universal

    • Pays up to 500% of charges imposed by the medical profession
    • Unlimited cover for MRI, PET and CT scans
    • Co-payment cover, even when a Designated Service Provider is not used
    • Also annual cover for above medical aid rates for internal prosthesis (artificial joints)
    • Enhanced cancer cover, including cosmetic reconstruction procedures and cash payouts
    • Emergency room cover
    • Accidental death and permanent disability cover
    • Accidental dentistry cover
    • And also, trauma counselling

     

    The Essential

    • Pays up to 300% of charges imposed by the medical profession
    • Co-payment cover only when a Designated Service Provider is used
    • Emergency room cover
    • Accidental death and permanent disability cover
    • Also, trauma counselling

     

    What do a Universal policy or an Essential policy cost every month in 2019?

     

     

    Optional extras – Get a Zestlife Quote

    Clients also have the option to add extra cover to their policies for cancer, medical premium waiver cover and dentistry procedures.

    Who qualifies?

    Only members of medical schemes are eligible for Gap Cover

    How do I apply? – Get a Zestlife quote

    Complete the form on this page to get a Zestlife gap cover quote

    All info was correct at time of publishing