You did the responsible thing by joining a medical aid as soon as you started your first job.
However, the first time you suddenly need to go to hospital, you discover that the doctor or doctors who attend to you are not contracted to your medical aid and charge private rates. As frustrating as this may feel, there is a solution.
GAP COVER helps to cover the shortfall between what you, the patient, has to pay, and what the medical aid is prepared to reimburse.
Benefits of Gap Cover Insurance
Medical aid rates refer to the amount your medical aid is willing to pay for a particular service. Each scheme has its own Medical Scheme Rate which is created using the National Health Reference Price List (NHRPL) as a guideline.
Private rates are charged when doctors and other service providers opted to contract out of the medical aid. Often these prices are significantly higher than medical aid rates, which proves to be rather challenging to your budget.
With such a myriad of medical aids from which to choose, finding the best plan for you and your family can be a perplexing task. It is often difficult to determine the actual cost of treatment when looking at the Rand value offered for that treatment within the plan, or even if that treatment is appropriate for your combination of diagnosis, underlying conditions and health.
If you are a young family in need of:
- 600% Gap Cover,
- an unlimited annual Gap Cover,
- unlimited out of network non PMB’s and oncology treatment above scheme tariff,
- And various other benefits subject to hospital admission,
- at a reasonable rate of only R130.00 per month
Note: All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.
The information and opinions expressed here are believed to be accurate, based on the best judgement available to the authors, and readers who fail to consult with appropriate health authorities assume the risk of any injuries. Errors and Omissions Excepted. Terms and Conditions Apply.