Why Gap Cover is Essential for Medical Scheme Members
Medical costs ever on the increase. So it is important to start considering how to cover the gap. Gap cover is essential. If you do not have gap cover, you might have to pay expensive medical bills.
If you are a member of a medical scheme, you may believe that you have full cover if you need emergency medical treatment.
You could well be wrong and end up paying the price for that.
You might reach the limits that your medical aid scheme will pay a lot more quickly than you may realize.
Even if they do pay the prescribed minimum benefits as required by law, there is no guarantee that your doctors, etc. will charge standard medical aid rates.
Therefore gap cover is essential. We list the companies where you can get it below this article.
Gap Cover is Essential for the Shortfall
That is where gap cover is essential. It will pay the portion that the medical aid does not.
Which Company to Choose?
Here is a rundown of the top gap cover providers in South Africa
You will receive cover from as little as R245 a month up to a maximum of R466 a month. There is cover for procedures done in the hospital in addition to:
- Costs related to co-payments for treatments in the hospital
- A lump sum benefit should you be diagnosed with cancer
- A lump sum benefit of R50 000 should you be permanently disabled in an accident or die in an accident
- Extended cancer and dentistry cover are optional extras
Cover from Stratum will cost you either R99 per month or R168 per month. Each plan allows for gap cover that is unlimited.
You will have cover for:
- Costs related to the doctor’s fees and the specialist’s fees
- Cost related to co-payments
- The comprehensive plan includes cover for CT and MRI scans and a whole host of other treatments in the hospital.
Look at paying between R79 a month and R124 a month for cover with Turnberry.
Cover provided is up to a maximum of 5 times the medical aid tariff if you lan in the hospital.
You can choose the Elect-A-Care Standard Plan to be covered for:
- Some scans out of hospital
- Expenses incurred when in the hospital
The Elect-A-Care Plus plan includes the above benefits plus a range of co-payments for treatments in the hospital and several more benefits for expenses incurred out of the hospital.
The Elite plan will cost you R140 on a month to month basis.
This plan excludes cover for co-payments and sub-limits.
The cover will pay out the shortfall up to 5 times standard medical aid rates with a total cover of R250 000 on a year to year basis.
The Prestige plan will cost you from R160 on a month to month basis. That will cover both you and your family.
Ambledown a premier gap cover product.
They will pay out up to 500% of the standard medical aid rates with a cap of R2 million annually for a family.
Expenses incurred in the hospital are covered.
Cover for outpatient treatments for chemotherapy and radiotherapy.
Outpatient treatments for renal failure are also covered.
The cover here starts at just R61 on a month to month basis, meaning that there are no excuses that you cannot afford it anymore.
If you want a more comprehensive policy, you will pay R121 on a month to month basis.
The package on offer from Xelus, the Fusion plan, is designed for employers.
The cover extends to shortfalls of any kind.
If you are looking for value for money, this is a great option.
Pay from R115 on a month to month basis for you and up to four other close family members.
Sirago has no limits regarding age of entry and no limits on an annual basis either.
They also cover optometry and dentistry as long as it is performed in the hospital.
That is basic gap cover.
Talksure is one of South Africa’s leaders when it comes to gap cover.
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