Where Can I Get Medical Gap Cover?
December 19, 2021
South Africans have dozens of companies where they can get medical gap cover. There are literally dozens of companies offering this form of short-term medical insurance. Consumers are also spoilt for choice when it comes down to budget constraints. It is possible to purchase Gap Cover from around R100 a month, escalating up to the R500 monthly premium mark. But remember the cheaper the policy the less the benefits. In other words, consumers get what they pay for.
Why is Gap Cover Necessary?
Gap Cover has become an integral part of medical portfolios. It pays the difference between ceilings set by medical aid schemes for hospital procedures and amounts asked by the medical profession for services rendered.
Many people are under the misguided belief that they are fully covered by their medical aid for in-hospital treatments. Nothing could be further from the truth. Medical schemes work on tariffs set by the National Health Reference Price List (NHRPL) which fall way below what medical practitioners charge for their expertise.
An example is heart bypass surgeries which costs about R350 000. Medical schemes pay R250 000 for this procedure, leaving the patient with a whopping R100 000 shortfall. Gap Cover will pay in this difference.
It has become common-place for the medical profession such as surgeons, anaesthetists, radiologists and pathologists to charge up to five times more than what medical schemes will pay according to the NHRPL tariffs.
Who Qualifies for Gap Cover?
Applicants must be members of a registered South African medical aid scheme to qualify for Gap Cover. Other qualification criteria could be age limits and the fact that families must all be members of the same medical aid to be covered by a Gap policy.
Where Can I Get Gap Cover?
As stated earlier, there are many companies that offer this form of short-term insurance. Consumers are now able to investigate their options and apply for Gap Cover online. They can now receive their insurance policy in a matter of minutes. Here are just a few examples of companies offering Gap Cover:
As an example, Jenius Health offers to cover tariffs up to five times more than the amount paid my medical schemes. Policy holders have a limit of R1 million annually. The policy covers oncologist and cancer-related surgeries up to a maximum of 600% annually.
All info was correct at time of publishing