Understand the Importance of Medical Gap Cover

December 19, 2021

You can no longer put all your hopes in your medical scheme to take care of all your health needs. The importance of medical gap cover to insure any shortfalls is vital.

Remember: medical specialists can charge you up to 5x more than the standard medical scheme rate. A typical example of this is a hip replacement – common surgery for many South Africans as they age. For this operation, you could be looking at a shortfall amount of R24 617 which your medical scheme won’t pay. You will have to find that money from somewhere. That illustrates the importance of medical gap cover.

Before you slate your medical scheme, however, they do try to cover most costs. However, conventional medical aid funds do not cover the fees of some practitioners. So they aren’t able to pay for these ‘over-and-above’ amounts. Gap cover ensures that medical aid members have a way of covering these uncovered expenses.

Mercifully Gap Cover is Within Everybody’s Reach

Do research among the top medical gap cover providers in South Africa. You will find that gap cover is a cheap way to meet shortfalls. Those are the co-payments you often have to pay before treatment begins.

No wonder that Presodhini Naicker, Head of Brand and Marketing of Old Mutual iWYZE stresses the importance of medical gap cover. In fact, Naicker says that medical gap cover has become a must-have for consumers.

When choosing a registered medical scheme, you’ll discover that medical aids cover professional services in the hospital at 100, 200 or 300% of the scheme rate.

You might think that means you won’t have to pay a cent. However, specialists charge far more than 100%, an amount your medical aid won’t pay. Gap cover will take care of this.

Gap cover isn’t part of your medical scheme membership so it is therefore does fall under the same laws as a medical scheme. Medical schemes follow the rules and regulations of the Council for Medical Schemes while Gap Cover falls under the Short-term Insurance Act. The Financial Services Board (FSB) regulates gap cover.

There are some medical aid members who carefully consider the current medical aid plan they have. They then decide to go without some of the more luxurious cover that they believe they can get by without. This can be a huge risk though, and it’s a financial decision not to be taken lightly. Don’t be afraid to ask questions about medical gap cover.

Medical Gap Cover is something that you can only invest in if you are already a member of a registered medical scheme.  Speak to a Medical Aid Consultant to understand precisely how gap cover comes into the picture and why it is such a critically important accessory to your medical aid scheme.

Gap Cover – Critically Important Must-Have Accessory

Apart from offering insurance for cars, homes and household content, iWYZE offers gap cover too, so medical shortfalls will be taken care of. You’ll receive cover for surgical procedures as well as cover for in-hospital medical treatments.

For certain procedures, your medical aid will require you to first pay a certain amount upfront. It’s known as a co-payment and some medical aid members can’t go ahead with treatment because of these annoying co-payments which they’re unable to pay. However, with gap cover, you won’t have to worry about these payments.

Importance of Medical Gap Cover – Relief from Financial Strain

Gap cover covers the principal member of the medical aid scheme and also their registered spouse and children. Underwritten by Old Mutual Insure Limited, iWyze can be contacted for gap cover via their website or by calling them on 0860 93 94 93. It can be such a relief handing all the financial strain of soaring medical bills in the hands of gap cover. and emotional strain of your medical bills with

Complete and submit the form on this page to sign up for medical gap cover

All info was correct at time of publishing