Questions to Ask Regarding Gap Cover

December 18, 2021

When it comes to your medical aid cover, there are questions to ask yourself. One question: Do I have sufficient cover? Will there be any shortfalls? For some, having gap cover as an extra to their medical scheme is simply for peace of mind while for others, it is essential. Knowing in which category you fall is very important before deciding to purchase gap cover. A lot of us don’t have space in our budget to fit in extra medical costs. So having gap cover while not necessary could be a waste of savings. To find out if you need gap cover, read the below questions that are important to ask regarding this benefit.

What is Gap Cover?

Before deciding to get yourself gap cover, you need to clearly understand what it is. Medical aid gap cover is an add-on financial supplement policy. More than often your medical aid scheme might not cover huge hospital bills in full and having gap cover will prevent you from being responsible for these.

What does Gap Cover Include?

Questions to Ask

Gap cover includes the shortfall between what your medical aid scheme pays out and the actual medical expenses. It also includes expensive, specialised treatment and procedures that might not be covered by your policy.

What Are Your Current Medical Aid Scheme Rates?

It is important to know what your medical aid rates are. Some pay out at 100% while another payout at up to 500%. The lower this rate is, the higher your gap cover amount will need to be.

Questions to ask about the Requirements

Although gap cover insurance is to cover the unexpected, knowing your health conditions and thus requirements will be to your advantage. Some health conditions have a high possibility of needing specialist treatment and having gap cover for these is a great idea.

Expect the Unexpected

Thinking about the unexpected in life is extremely necessary. You could be diagnosed with a life-threatening condition such as cancer or a heart disease in the blink of an eye. Even medical aid schemes with higher premiums more than often set limits on how much they will pay for treatment and emergency procedures. Enquire about how much your medical scheme will pay for these. To ensure that you choose a gap cover plan that covers the shortfall.

Questions to Ask about your Existing Benefits

Upon deciding on a medical aid scheme, inquire about what exactly is covered in your chosen policy. Medical aid schemes with lower premiums tend to provide fewer benefits and pay out less than those with higher premiums.

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All info was correct at time of publishing