Gap cover is not just a nice to have. It should be an essential part of your medical policies, as unfortunately, unforeseen events can happen. Gap cover will help you in instances where there is a shortfall between what a service provider will charge and what your medical aid scheme will cover for in-hospital expenses, as not all medical expenses will be covered by your medical aid scheme.
What are my Gap Cover provider/company options?
There are a lot of gap companies to choose from and it is really up to you in terms of what you need as well as what suits your budget. A good idea is to check in with your medical aid scheme to find out what gap cover plans work well with them as you could minimise the administration in this way.
It is probably in your best interest to chat to an advisor, who works with a number of medical aid and gap cover companies, to be able to get the best plan to suit your needs. Bare in mind that you cannot get a gap cover plan without having a medical aid plan in place.
How do Gap cover plans differ?
Most gap cover plans work roughly the same way and provide the type of cover that you need. There are often different product plans or tiers under each company and they might provide additional coverage including family cover and rates. But most plans work the same, assisting you with that in-hospital shortfall.
Pricing is also another factor that people consider when choosing a plan, so make sure that you don’t just pick the cheapest option without doing your research first.
Remember that you are in control of your options, and if you have done enough research and had a medical aid advisor weigh in - you have the choice on what plan will work for you.
How does Gap cover work?
In order to help explain, let’s look at an example of some common procedures:
|Procedure||Actual cost||Medical aid payment||For your account|
|Hysterectomy||R12 978||R4751||R8 227|
|Coronary bypass surgery||R40 752||R13 588||R1 959|
|Surgical wisdom teeth extraction||R8 227||R27 164||R4 302|
*The values in the table are illustrative only, actual costs and medical aid contributions vary across providers. Ref: https://www.medicalaid-quotes.co.za/articles/gap-cover
So just using some common examples, you can see where and how you can save when you have a gap cover plan in place to close the gap, giving you peace of mind knowing that you can afford the care that you and your family need.
Gap Cover Questions & Queries
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 judgment 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.