What Accounts for Medical Gap Cover’s Popularity

March 2, 2022

It’s enough to bring tears to any medical aid member’s eyes. Medical schemes are becoming so expensive that very few can afford them. Even after contributing huge monthly premiums, members expect their medicals to pay all their bills. But they do not. Patients have received huge medical bills for which they’ve had to take out loans to pay. It’s this kind of scenario which accounts for medical gap cover popularity.

Medical aids are charging higher and higher rates, so it makes sense to get an insurance product like gap cover. Without gap cover, you’ll have to pay the gap between what the medical aid is willing to pay and what the specialist who isn’t regulated charges. Gap cover only pays for in-hospital care and not those day-to-day medical expenses.

Reasons for Medical Gap Cover Popularity

  • Gap cover protects those who belong to a medical aid from the shortfalls that occur with so many treatments not covered by PMBs.
  • Cancer treatment.  Patients need to know that there are exclusions for some cancer treatments.Many people wish they had known this before they started with a cancer diagnosis because they would have chosen gap cover. Gap Cover provides an additional amount to assist with paying for shortfalls on these treatments.Gap Cover Popularity in South Africa
  • Most medical schemes have an unlimited overall benefit. That doesn’t mean you will always have complete cover. Many of the benefits in your plan have sub-limits. These cover only parts of the procedure. That means that you may have to have the procedure done in a state hospital where in terms of your cover. Gap cover supplements a medical scheme – a short-term insurance makes sure your gaps are covered regarding sub-limits, deductibles or co-payments so that you don’t ever have to put off going ahead with treatment.

Another Reason for Gap Cover Popularity

  • Many South Africans are choosing hospital plans over the very expensive medical aids, but hospital plans aren’t free of sub-limits. If you run out of benefits under your hospital plan, without gap cover, you’ll have to resort to a state hospital for the completion of your treatment. The care you receive in a state hospital can often jeopardise your health further. Gap cover can make sure you have the cover that will take you through the entire treatment process uninterrupted.

For many medical aid members, gap cover has become a necessity as medical aid amounts are hardly ever paid in full. When you do the research, you will find that shortfalls with certain medical procedures can be as much as R100 000 – enough to bankrupt anyone. Everyone is affected by these shortfalls, from people on the most basic medical aid plans right up to the executive plans. The result has been a steady rise in the popularity of gap cover. It covers thousands upon thousands of members.

Make Use of Gap Cover While You Still Can

Even though consumers have to deal with rising gap cover premiums, gap cover is still affordable, and premiums can range from R300 a month to R600 a month, for tariff shortfalls. Gap cover is massively popular now because it can spare you massive financial stress with paying medical bills. The thing is, gap cover underwriting is coming under pressure, and it is also starting to rise sharply.

Medical aid costs together with gap cover costs are having a tremendous impact on how South Africans budgets. They are having to decide between putting food on the table or paying for medical care. Who knows where it will all end.

If you belong to a medical aid in South Africa, get a FREE gap cover quote on this page. Just complete and submit the form


All info was correct at time of publishing