Medical aid with no shortfall cover

November 26, 2024

There are cogent reasons why you should never have medical aid with no shortfall cover.

Here you are, paying as much as R6000 a month, for medical scheme membership with no guarantee that the medical scheme will pay all your healthcare costs.

Just about every medical aid member in South Africa knows this all too well.

Who hasn’t faced co-payments once the medical savings account has run out and the bills exceed the amount your medical aid is willing to pay?

Reasons to avoid medical aid with no shortfall cover

Every day the cost of healthcare rises. Hospitals import their equipment. Pharmacies import most of their medication. Specialists become more scarce as the brain drain accelerates. Private hospital rates increase due to greater demand as state hospitals collapse.

Gap cover (also called shortfall insurance or top-up cover) is a product that medical aids may not offer as they are statutory bodies. Instead short-term insurance businesses such as Zestlife supply these policies. While you have to be a member of a registered medical aid in South Africa to qualify for gap cover, the two types of health cover are totally separate.

Gap cover polices are inexpensive

In a sense, having medical aid without gap cover is wasting money. For a small monthly premium (about 10% of the equivalent of your monthly medical aid premium) you can wave co-payments good-bye.

It means you don’t have to change your medical plan to a higher level to get extra cover. Gap insurance does it for you.

And a single policy covers everyone on your medical aid.

There are waiting periods but these are very limited.

In addition, gap cover is easy to understand and there are only a couple of options. This makes a pleasant change compared to medical aid options which are many and complicated.

You can sign up by email and phone. Complete and
submit the form on this page to start the process.

 

All info was correct at time of publishing