With hospitals and medical service providers charging anything up to 500% or more above standard medical aid scheme rates, gap cover has become essential. If you’re thinking about gap cover, you should first consider the following: What exactly is gap cover?
Medical aid gap cover is an ‘add-on’ policy to supplement your medical aid scheme and prevent you from being responsible for huge bills not covered by your medical aid. This includes the shortfall between your medical aid payout and actual charges, as well as expensive, specialised treatments that may not be covered.
What are the benefits of your medical aid scheme?
Speak to your broker and find out exactly what is covered in your policy. Schemes on lower tiers, with lower premiums, have less benefits and pay out less than schemes on higher tiers. In addition, lower tier schemes are less likely to cover specialised procedures. Simply put, the lower your premium, the more medical gap cover you need.
What are your medical aid scheme’s rates?
Some medical aids pay out at 100% of their rates, while others pay out at up to 300%. The lower your medical aid scheme’s pay out rates, the more extensive the gap cover amount you will need. Do you expect to require any specialist treatment? Of course gap cover insurance is all about expecting the unexpected; however, if you have any known health conditions that have a high possibility of needing specialist treatment in the future, gap cover is a good idea.
What about the unexpected?
No one expects to be diagnosed with life threatening conditions, such as cancer or heart disease. But it happens, so best be prepared. Many medical aid policies – even those with higher premiums – set limits on how much they will pay out for treatments and emergency surgical procedures. Find out what and how much your plan will pay for, to ensure that you choose medical aid gap cover that covers the shortfall. For further information on medical aid and gap cover options, contact us today.
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