Stratum Gap Cover Premium Waiver
April 26, 2020
Stratum Benefit’s Elite option is fast becoming one of South Africa’s leading products in the field of medical shortfall cover. With a truly comprehensive range of benefits available at an affordable price, an Elite policy is highly recommended for anyone looking for extended cover on their existing medical aid or hospital plan. Consider getting Stratum, with the Stratum gap cover premium waiver benefit.
Most medical aid schemes and hospital plans have specified limits on what they will pay for certain treatments, medications or services. The outstanding amount will then become the responsibility of you, the member. By joining Stratum Benefit’s Elite plan, you can also ensure that these unanticipated expenses will not cause financial difficulties in times of medical emergencies. Let’s take a look at the benefits that the stratum gap cover premium waiver can offer you.
GAP BENEFITS – Stratum Gap Cover Premium Waiver
Because private medical providers often charge more than your medical aid covers, a “gap” or “shortfall” often exists which you must then pay. By offering up to 500% of specified rates, Elite cover ensures that you will not be left struggling to pay for unexpected costs relating to:
- Consultations with medical specialists
- Basic X-rays (excludes CT, PET and MRI scans)
- In-hospital medication (excludes take-home medication)
- Hospital consumables, such as gauze, bandages, surgical gloves, etc.
Elite offers unlimited annual claims on Prescribed Minimum Benefit (PMB) procedures, as well as for services received in registered doctors’ and specialists’ rooms, hospitals and day clinics.
CO-PAYMENT BENEFITS – Stratum Gap Cover Premium Waiver
In cases where it is necessary to pay up-front costs before a medical procedure is carried out, Elite will pay an unlimited number of claims each year to cover costs for certain treatments and procedures.
ONCOLOGY BENEFITS – Stratum Gap Cover Premium Waiver
Stratum Benefits understands that cancer is one of the most disturbing and expensive medical conditions. To remove the financial stress associated with this conditions, Elite cover offers comprehensive co-payment benefits for oncology, including:
- Oncology treatments (chemotherapy, radiotherapy, etc.)
- Specialised radiology
- Specialised medication
- Specialist consultation
Also, a once-off Cancer Diagnosis Benefit is also available, paying out when you are first diagnosed with cancer. And for extra assurance, an Oncology Optimiser Benefit is also available if required.
CASUALTY BENEFITS – Stratum Gap Cover Premium Waiver
The Elite Casualty Benefit exists because an accident can occur at any time, requiring immediate medical attention. The casualty benefit provides cover for:
- Basic X-rays
- Consumable medical items
- Medicine provided as casualty care
- Up-front co-payments for casualty care.
The sub-limit benefits apply when your medical aid does not cover the full cost of internal prostheses. Also included in these benefits are CT scans and MRI scans.
Because Stratum Benefits recognises that not all medical attention is physical, Elite also offers outstanding benefits for trauma counselling. This includes the services of counsellors, psychologists or psychiatrists. Trauma counselling is often recommended in cases where you were involved in, or witness to, violence or an accident that resulted in serious harm or injury. Counselling is also available in the diagnosis of dread disease.
ROAD ACCIDENT BENEFITS
The process of claiming from the Road Accident Fund is not an easy one. Elite offers to not only handle the claim for you but also to facilitate the process. This ensures that you receive the full compensation you deserve without the associated stress.
The elite cover also recognises that your financial position could well change over time. To minimise disruption, Elite offers the following advantages:
- Gap Policy Premium Waiver, which will also pay your Stratum Benefits for up to one year following the forced retrenchment, permanent disability or death of the premium payer
- Medical Scheme Contribution Waiver, which will pay your medical scheme contributions for up to six months in similar circumstances, ensuring that your family can continue to receive medical services
- Accidental Death Benefit, which pays after the accidental death of the principal insured, your spouse or a dependent.
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All info was correct at time of publishing