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How Does Gap Cover Enhance Your Medical Aid

Person being loaded into ambulance

Meet John and Joe. Brothers who are often mistaken for twins, John and Joe are two peas in a pod. Both are young, single, professionals. However, these siblings have two opposite outlooks. John lives life to its fullest, and his motto is “Live fast, die young”. Joe, on the other hand, has a more conservative outlook, and his motto is, “You can never be too careful”. While both have excellent medical aids, Joe has opted for Gap Cover too.

Why should John take a leaf out of Joe’s book?

What Does Gap Cover Protect?

Medical aid is essential in South Africa. Medical Aid schemes use a pre-determined set of tariffs/rates as a guide to what they will pay. It lists a suggested price for each item charged by the medical profession.

However, many surgeons, anaesthetists, doctors, etc. regard their care as specialised, and therefore charge higher than the listed prices. This is when you will experience a shortfall between what is being charged and what your medical aid is willing to pay.

How Does Gap Cover Enhance Your Medical Aid?

Let us look at John and Joe again. If they were both admitted into hospital, their medical aids would pay for their in-hospital medical costs. However, the bills that arrive after their discharge – from the medical specialists who charge more than what the medical aid paid – would be a shock for John; but the shortfall probably covered by Joe’s Gap Cover.

Gap Cover is not an additional medical aid or a substitute for medical aid. It is short-term insurance to cover you in cases where you have a gap in your medical costs. Your medical aid needs to pay their portion first.

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 and 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.


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