People are often under the misunderstanding that their comprehensive medical aid will cover them for any medical expenses they may incur.
So, when you receive medical bills that your medical aid has not covered, you are shocked beyond belief. This is where you would need medical GAP COVER.
There is nothing quite as horrific as that sinking feeling as the bills start flowing in after you’ve had some or other surgery and you’re still convalescing. You are bed-ridden and still trying to figure out where you’re going to get the money to pay for all these additional expenses. It’s the very last thing a recovering person needs.
GAP COVER Can Help
No matter which plan you are on, there can be a shortfall between what the medical aid scheme will pay and what the service provider has charged. Service providers are well within their rights to charge way above tariff rate and they often do. This shortfall (gap) is the member’s (patient’s) responsibility. In the case of service provider costs for treatment in ICU stays, for example, this gap could run into hundreds of thousands of rands. The financial implications could be crippling.
Many comprehensive medical plans and hospital plans offer cover at 100%, 150% or 200% of the medical practitioner tariff rates. However, many service providers charge 400% or even 500% medical aid rates. In this case, GAP COVER will settle the balance (Up to 700%).).
If you have medical GAP COVER, you can relax and rest assured… or should we say: rest insured. This type of policy will make sure that the shortfall which is not covered by your medical aid will be paid and you can simply focus on getting healthy again.
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