Read all about the new rulings on Gap cover
December 12, 2021
The National Treasury has introduced new rulings on Gap cover. Find out if the new medical Gap cover rules affect you?
The new rules state that hospital cash-back plans can only pay out R3,000 a day or R20,000 per year. Plus, there is an R150,000 payout limit per annum for each member. This is so as to prevent doctors from charging high tariffs.
The regulations will also outlaw primary health care policies from 1 April. With lower contributions than a medical scheme, their membership hasn’t seen significant growth either.
Besides which, Primary health care policies aren’t really medical schemes and provide limited medical benefits. They’re also not governed by the Medical Schemes Act, and have in fact put people off from joining medical schemes.
Medical Gap cover Rules and You
With gap cover as it now stands, it is believed that the proposed new low-cost benefit options will effectively cover the gap that exists when your medical aid don’t settle medical bills in full.
National Treasury also wants there to be a distinct difference between medical scheme products and health insurance. Each one is regulated by different Acts and this in itself is causing confusion. These new regulations came into effect on the 1st of April 2017 for new policies and from January 2018 for existing policies. Another bonus is that before you couldn’t get gap cover after the age of 65, but the new regulations now allow this.
People are often amazed to discover that their medical aid plan does not cover their bills. Paying for huge medical bills when you already belong to a medical aid is a cause for great stress, but gap cover has come to the rescue. Gap cover isn’t something that is an add-on to a medical aid. It has become vital, without which, you could go under financially.
Gap cover is the lifeline thrown to South Africans to provide peace of mind in a health crisis. It is important that employees are assisted by a professional broker as to what gap cover is best for them, especially now that there are new medical gap cover rules in 2017.
Gap cover doesn’t replace medical scheme cover, but it enhances it. It pays for bills that medical aid won’t cover.
Gap cover Covers for You Time and Again
Today in 2017 with medical gap cover, we have a host of providers that offer cover at competitive prices and which will ensure that your medical aid never gets the better of you.
All info was correct at time of publishing