Liberty Medical Gap Cover Costs

    Liberty medical gap cover offers you protection against liabilities arising from any shortfalls that may result from the cover provided by your medical scheme.

    Most scheme members expect that their scheme will meet all of their expenses, but in reality, this is not often the case.

    The benefits that a scheme offers agree with those detailed in their Medical Scheme Tariff (MST). However, many medical professionals will charge fees more than a scheme’s MST. And some specialists even charge four or five times the tariff. Yes! Now imagine trying to find the cash for this bill.

    Medical aid members can apply for one FREE medical gap cover quote
    by completing and then sending the form on this page

    Gap Cover is All About the Shortfall discrepancy Between Your Medical Aid and Reality

    You then need to cover this gap or shortfall, out of your pocket. And the actual cost to you can be quite considerable when you add up the surgeon, anaesthetist, and other medical professional fees.

    Fortunately, Liberty medical gap cover offers cover to the policyholder, and their dependents as well, up to and including R250,000 per person and R2,500,000 annually for a family.

    Additional benefits added to the Liberty medical gap cover policy include:

    General Co-Payment Benefit – payment to cover unexpected shortfalls for some procedures up to a maximum of R20,000 for a family during one year. And that will usually cover co-payments arising from your medical scheme.

    Oncology Co-Payments – A one off payment of R10,00 if you have breast or prostate cancer on top of any other treatment shortfalls. And Liberty covers a co-payment with a 20% limit of the threshold.

    Gap Cover for Liberty Health

    Why You Should Choose Liberty Medical Gap Cover

    1. Liberty covers an unlimited number of dependents with no age limits
    2. It is a well-established product with one of the most comprehensive lists of outpatient procedures covered
    3. Exclusions are: in-hospital treatments for dentistry, Prescribed Minimum Benefit conditions and hormone and fertility treatments.
    4. No 12-month pre-existing condition waiver, we offer condition-specific limits.

    Information You Need to Know

    Limits on benefits – the benefit they provide is the difference between what your medical scheme pays, up to a limit of five times the Admed charge. Liberty pays benefits up to R250,000 per individual and R2,500,000 per family.

    Waiting periods – Liberty does not pay benefits during the first three months after a policy starts but this does not include compulsory group schemes.

    Benefits for children and Childbirth claims will not be paid during the first ten months.

    Arthroscopic procedures, joint replacements, nasal surgery including sinus-related surgery, hysterectomy, dentistry-related claims, cataract surgery, all hernia repairs, and cardiac related surgery and procedures, and spinal surgery including spinal fusion do not qualify for benefits during the first six months with 50 percent benefits during the second six months.

    These limitations are not applied when a claim arises because of injury or accident, where hysterectomy is needed to satisfy oncology treatment and with cardiac surgery that was not diagnosed before the policy commencing.

    Exclusions – no payments are made resulting from standard exclusions as detailed in your policy document. Some other exclusions also exist. And these include cosmetic surgery and treatment for obesity and cancer treatment outside of South Africa.

    Excluded Costs – Hospital charges such as medication, prostheses, and other materials are specifically excluded.

    How much is the policy? The Principal Member has cover for R173 a month and cover extends to the dependents in the Principal Member’s medical scheme.

    Liberty Medical Premium Waiver

    Medical Premium Waivers are important as they protect your dependents if something happens to you and you cannot make future premium payments.

    What is Medical Premium Waiver?

    The Liberty Medical Premium Waiver Policy offers Principal Members comfort that their dependants have cover if they die or become disabled and unable to work. Cover provides a monthly payment that covers the entire medical scheme contribution up to R4,840 for either two or five years.

    Importantly, pre-existing conditions that were diagnosed 12 months before the policy start date, or are diagnosed 12 months after the policy starts are not covered.

    No cover for claims arising from suicide, self-harming or from injuries arising from acts of war or crime. are also not covered. In the event of disability, then the benefit is paid after 30 days and for 24or 60 months or until the policyholder recovers.

    Liberty Health is Here for You and the Well-Being of Your Family

    Liberty Health finds ways of making quality healthcare affordable to protect you and your family from unplanned medical expenses. No one provider can meet everybody’s complete needs so Liberty offers cover using the best skills in the marketplace.

    Our solutions offer healthcare to cover a wide range of needs. Those needs can be risk-based or simple medical products. We understand that as cover gets more and more expensive, then people need more inventive way of providing cover.

    We have ordinary people as clients, and we help to make their medical cover affordable and manageable.

    Offers from Liberty

    • Affordable, easy-to-understand medical cover
    • Solutions to fit your personal circumstances
    • Top quality healthcare providers

     

    Your Needs Our Solution

    Medical Gap Cover – Closing any gaps between MST and actual provider costs

    Medical Premium Waiver – Safety of guaranteed cover if you are unable to work

    How Much Does It Cost

    Our costs are very reasonable and amongst the best value around.

    Individuals Monthly cost

    Medical Gap Cover R173
    Premium Waiver – 24 months R125
    Premium Waiver – 60 months R218

    Medical Gap Cover for Employees

    Monthly Cost

    When compulsory, then less than five members R160
    When voluntary, then less than 24 members R165

    So Liberty offers you a range of gap products to meet  everyday medical requirements

    Medical aid members can apply for one FREE medical gap cover quote
    by completing and then submitting the form on this page