What Is a Medical Co-Payment?

December 18, 2021

Many people who have medical aids are not even aware of the term ‘co-payment’. Here we will go through what is a medical co-payment.

They are unaware of these co-payments until they require a certain medical service. A medical aid co-payment is a certain fee that you, the member, are liable to pay when you use medical services.

Your medical aid may well not pay out the 100% they promise for your treatments. That means that you must first pay your portion of your medical bill before your medical aid pays anything.  Many people are unable to do this.

What Is a Medical Co-PaymentCo-payments usually apply to specialists or elective procedures like dentists for example. That means you need to research medical aids before joining one, and perhaps look at choosing one that does not require co-payments from its members.


Everybody needs Help to with Paying Medical Bills – What Is a Medical Co-Payment

Co-payments can be pretty costly too.

It can certainly be the case if your medical procedure is carried out by a specialist.  Medical aids are an excellent tool to help you manage your medical demands, but you might require further help.

That is gap cover. Many people are starting to opt for this kind of cover to help them deal with co-payments. Or any medical shortfall that their medical aid won’t pay and which they must pay for. And out of their pocket too!


Research the right Medical Aid – What Is a Medical Co-Payment

When you join a medical aid, you need to check that your monthly premium will be within your means. Checking to see what co-payments or deductions will be taken off when you claim from your medical aid.

If your health insurance policy has a co-payment clause, you will have to agree to pay a part of the medical expense out of your pocket. There is some medical scheme’s who have this co-payment clause in their policies. Larger co-payments usually mean lower premiums for the insured.

A benefit for the medical scheme is that these co-payments discourage people from making claims considered as unnecessary. It also discourages them from having treatments in expensive hospitals.

Understanding how medical aid gap cover and co-payments work are amongst the important factors to consider when you shop around for medical aid. These co-payments, just like an excess on your motor car insurance are imposed by the medical scheme. As a short term insurance policy, it’s a clause to help the medical scheme not lose too much money.

Can ANYONE Afford Co-payments?

Health care costs are sky-rocketing. Those who can still manage to pay for medical aid are experiencing fewer benefits, higher premiums and co-payments which they don’t have money for.

It’s a fact that co-payments can save the insurance company a substantial amount of money but what about you? Therefore before you invest in a medical aid plan, check out whether they operate with co-payments.


To get a FREE gap cover quote, complete the form on this page and click on the “Get a Quote” button

All info was correct at time of publishing