Why you need basic cover if you belong to a medical aid

December 10, 2021

At the very least it is crucial to have basic gap cover to complement your medical aid membership. But why is gap insurance so essential?

Remember that your medical aid will probably not pay all your specialist and hospital expenses if you need to claim. The chief reason for this is that medical schemes pay only the prices that appear on their own, internal tarigf list. They do NOT pay the amounts that appear on the bill.

So if your medical aid plan claims to pay 100% percent of costs, that means 100% of the internal tariff list and NOT the actual amounts incurred. What makes this insurance indispensable is that it pays the gap between the amount the medical aid agrees to pay and the actual figure that appears on the bill. If you are critically ill and need specialist care in hospital, you could land up with major out-of-pocket payments. But that is only if you are without this vital addition to your health cover plan.

Basic gap cover for medical aid members in South Africa

So that’s why gap cover is important

If you are a medical aid member in good standing, it is necessary for you to buy gap cover separately. That is because specialised short-term insurers (such as Zestlife, Turnberry, Stratum and so on) supply this particular product. Medical schemes themselves have nothing to do with it.

Don’t worry if you have several beneficiaries or co-dependents on your hospital plan. One of the key benefits is that one policy covers everyone on the scheme – no matter their age or relationship to you.

Another main advantage is that gap cover is so affordable. For a small monthly premium (about half the price of insuring a new, medium-sized vehicle) you can be sure that your principal shortfalls will be paid in the case of major expenses incurred.

So do the right thing. Use the useful contact form on this page to get hold of a leading gap cover firm. They will contact you with a quote. Do it now!

All info was correct at time of publishing