Upgrade your medical aid – or do this instead

November 24, 2024

You may not have to upgrade your medical aid membership.

Perhaps you are running out of medical savings before the year is over.

Or perhaps you have had high co-payments.

Yes, you could get a more expensive medical plan.

But there is another way to go.

You could avoid an upgrade to your medical aid

Consider this: if you retain your current medical scheme option, or even go down one level, you could always make up for the cover you want by getting gap cover.

Gap cover is also called shortfall or top-up insurance.

And with good reason.

The main reason for having gap cover is to avoid expensive out-of-pocket co-payments.

Here are a couple of points you need to know about gap cover:

Basics of gap cover

• Everyone on your medical aid gets cover from a single policy
• Only members of official medical schemes in SA qualify for gap cover
• Short-term insurance companies offer gap cover. Not medical aids themselves.
• It does not matter what medical aid you are on – Selfmed, Topmed, Polmed, GEMS, Discovery, Bonitas, Genesis or one of the multitude of other schemes. You qualify for gap cover.
• If you only have health insurance such as from Clientele or Ubuntu, you do not qualify for gap cover.
• Cover takes effect immediately with a limited number of reasons for waiting periods.
• A typical monthly premium amounts to roughly the equivalent of 10% (ten percent) of your monthly medical aid premium.  So if your monthly medical scheme premium is R4000, for instance, then your gap insurance premium will be about R400.

 

Gap cover is cheap. Just check out the table below from Zestlife, which is the gap cover company we recommend.

Then use the form on this page to request your customised gap cover quote.

 

Get your personal quote by completing and submitting the form on this page

All info was correct at time of publishing