KaeloXelus Corporate Gap Cover
July 9, 2022
We at KaeloXelus understand that the health of our members is of great significance. Access to the best healthcare for you and your family is what you want.
Rising medical care costs together with medical policy benefits that are reducing. That means gap cover is ever more vital, to bridge the gap between medical scheme limits and healthcare bills.
KaeloXelus Fusion Solution
The Fusion solution for gap cover ensures shortfalls occasioned by medical aid are bridged. Oncology treatments are one area that this gap cover comprehensively covers, as well as surgeon account gaps. This gap cover solution also includes Sub-limits and co-payments applied by medical schemes, in addition to other deductibles. Fusion complements medical health covers, settling any unexpected bills resulting from major medical treatment. Fusion allows members not to worry about ensuring that they possess financing that makes sure their wellness and health safe.
To fully cover the health and mental wellbeing of you and your family. A solution known as Fusionx integrates the EAP (Employee Assistance Programme) with the Fusion benefits.
Charges in the fine print
Anaesthetists or surgeons charge quite a bit more than the price your medical policy, resulting in shortfalls. Fusion provides an additional 500% benefit of a tariff, usable in covering gaps. This applies to members seeking treatment in day clinics or hospitals, as well as specialists’ practices within hospitals.
Fusion covers all procedures, including minimal benefits. It also covers practitioners who contribute to your treatment. For example physiotherapists, pathologists, radiologists, surgeons, and so on. No currency limit applies in the use of this gap cover solution.
Individual healthcare events gather in further non-medical expenses that medical aid doesn’t cover. The Benefit Extender is there to aid with paying for such outcomes. These benefits cover more than is applicable with core benefits and is usable at the member’s discretion.
Family Booster relates to premature births over six weeks ahead of their due date. Fusion pays you R12, 000.
Hospital Booster pays according to the amount of a hospital stay, in lump sum:
- From a week to day 13 pays out R600 a day
- A fortnight to a day 20 compensates a daily rate of R1, 200
- Also, three weeks to a month gives you R1, 800 daily
For trauma related events, the benefit pays out from the first day, and not from day seven.
Family Protector protects against permanent disability to either the principal member or their beneficiaries. A lump sum payout of R12, 000 is applied in this case, doubling to R24, 000 for accidental causes.
Should a medical scheme leading member become disabled or die. Fusion gap cover by KaeloXelus will underwrite six months’ worth of medical plan premiums. Topping out at R4, 000 monthly, while entirely waiving the Fusion premium for six months. That is known as the Contribution Waiver Benefit Extender.
The RAF or Road Accident Fund is for you that have been i9n an accident. Together with Road Cover, they legally assist you in filling a claim. KaeloXelus will cover the legal bill at no extra charge.
If you belong to a South African medical aid scheme, please complete and send the form on this page. Then we will send you a personal gap cover quote
All info was correct at time of publishing