With the cost of living on the increase daily; and of course the cost of medication, specialist and hospital care, wouldn’t it be wise to find a way to cover major in-hospital medical expenses should they arise? Let’s face it, we don’t have the excess cash lying around or savings to cover the shortfall that medical aids don’t. That is where gap cover comes into effect.
The problem with medical aid schemes is that they do not cover you for the full amount; and the problem with us is that we do not always check exactly what we are covered for. Having to be in hospital or consult with a specialist is bad enough and then to be slapped with a hefty bill after the visit is enough to send you over the edge. Whether you are in hospital or an out-patient, gap cover will cover the shortfall on your account.
What is Medical Aid Gap Cover?
Medical aid gap cover basically covers the cost gap from what is covered by your medical aid and what the registered medical professional charges you. For example: You need to see a specialist (as an out-patient) and the total cost for the visit is R3000.00 but your medical aid will only cover R2000.00 of the total cost. Gap cover will then cover the R1000.00 shortfall that still needs to be paid to the specialist.
Think of it this way – motor insurance offers “top-up” cover that pays for costs that aren’t covered by your insurance company in the event of a claim and along the same lines, gap cover offers a medical “top-up” for excess charges.
Having prescribed minimum benefit cover as part of your gap cover tier is a huge advantage as it covers your co-pay, admission and penalty fees for the use of a non-designated service provider for prescribed minimum benefit treatment.
What else can Gap Cover offer you?
Gap cover is available in different tiered plans depending on what you feel your medical shortfalls could possibly be. Besides covering you for hospital account shortfalls, specialist consultation fee, out-patient and emergency room cover; you can also enjoy the benefits of:
- Health Premium Waiver
- Accidental Death Benefit
- CoPay, Admission and Penalty Fee Cover
- Accident Expert by RoadCover
- MediFin Medical Finance
- Medical Second Opinion
- Healthwise Dentistry Benefits
- Cancer Cover
- Access to 4me Lifestyle Mall
Gap cover is not a medical aid scheme and cannot be used for medical aid expenses. As with your medical aid cover, there is a three month waiting period before your gap cover can come into effect. Note that should you already have a pre-existing condition there is usually a waiting period of twelve months before gap cover can pay out.
Consider choosing gap cover – it will save you thousands!