Why Have Medical Gap Cover?

December 9, 2021

Many people today believe that when taking out medical cover, they have full cover for everything. They think that the medical aid will cover everything. That’s why they took out medical cover, right? Not so. So let’s answer the question: Why have medical gap cover?

When you took out medical cover, did you ever think to read that small print found at the bottom of your medical aid policy? If you didn’t, you might well be in for a shock when you discover that you might not have full cover at all. You might have arrived home from the hospital to find you’re being inundated with unexpected medical bills.

Why Have Medical Gap Cover?

Gap cover covers the gap between medical aids and doctors.

That is precisely why medical gap cover has been created. You might be asking – what is gap cover? A medical aid scheme will cover the tariff requirements prescribed by medical schemes, but you might not have realised that many doctors and specialists charge their rates. These can be considerably higher than the medical scheme tariffs. The difference in the prescribed medical aid rates and what some doctors and specialists charge is what are known as a shortfall as this is where gap cover comes in.

Why Have Medical Gap Cover

Why Have Medical Gap Cover? – It takes away Financial Stress

If you are a medical aid member, you will be able to apply for a free quote for medical gap cover, plus members of your family. They need to belong to the same medical aid as you. Once you know what the quote is, you can, for an extra monthly premium, take out this gap cover. Remember, gap cover is not part of your medical aid.

Taking out gap cover will give you peace of mind:

  • You won’t be in for any financial shocks after you have had a hospital stay and you find you are out of pocket financially.
  • Most gap cover products will cover from 400 to 500%. Some of them will even cover 600% of the medical scheme tariffs.
  • Some medical gap cover schemes add in benefits such as co-payment as well as accident cover. You will just need to research the one that will suit you and your family best.


Why have Medical Gap Cover? – It Fills in the Gaps

You might be asking the question – why do I need gap cover? Say for example you suddenly land in hospital. You suddenly need to have surgery in the theatre. Here you will receive treatment  doubt from both an anaesthetist as well as a specialist. After that, your stay in hospital will include in-hospital medications as well.

You do have medical aid, and they cover you 100% of your fees while in a hospital. But very often, the specialists and the hospital will charge you more than that 100%, sometimes as much as 400% more. You might not have realised this and be asking the question – who pays the difference? Well, it is none other than you. And this is where gap cover assistance comes in.

Get it!

The insurance companies will pay your gap cover payments directly into your bank account leaving you with the funds available to settle all those outstanding hospital and specialist bills.

Today’s stressful environment and difficult financial times can catch people off-guard. You cannot afford to get caught in a medical situation like this – it can cripple you financially. Today, gap cover is available for times like this, and the best news is, is that it is an affordable option for you and your family, some starting as low as R90 a month for a family of five. Find out about it today, you cannot afford not to!

To get a medical gap cover quote, just complete and send the form on this page

All info was correct at time of publishing