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Is Medical Gap Insurance Worth It?

Is medical gap cover worth it?

With everything, especially medical costs, increasing rapidly, do you really need another premium?

It might sound counterintuitive, but with increasing medical aid premiums, the difference between medical service fees and what medical aids cover is also widening.

Having gap cover is essential to protect oneself financially from unnecessary medical expenses.

What is Gap Cover?

Gap cover is a type of insurance policy that covers the difference between the amount paid by your medical aid scheme and the actual charges incurred for specific in-hospital treatment and procedures, hospital co-payments and out-of-hospital procedures.

Please note that you can only qualify for gap cover if you have a medical aid scheme. Gap cover is not a substitute for medical aid or a short-term insurance plan. It is also important to be aware of your gap cover policy exclusions.

Often, specialists set their rates higher than the medical aid tariffs, resulting in a “gap” or difference in what is charged and what you are covered for by the medical scheme.

This difference can be significant; you would be left paying hefty bills out of pocket without gap cover. Gap cover for these medical expenses is designed to ensure you are not left with unexpected costs.

Policies cover a percentage above the medical aid scheme tariff.

TRA’s entry-level policy will cover 300%, and our other three policies cover 700% above your medical aid tariff.

The Growing Need for Gap Cover in South Africa

The latest report on consumer inflation (February 2024) has pointed out that medical aid premiums have significantly contributed to the overall price increase. The report shows a whopping 10.3% month-on-month increase in medical aid premiums, which led to an annual rate of 12.9% for medical aid and health insurance.

Healthcare costs in South Africa have risen significantly, leading to a widening gap as medical practitioners charge fees beyond what medical aids can cover. This disparity can lead to significant out-of-pocket expenditures in case of medical emergencies or essential surgical interventions.

“The importance of gap cover has become more evident than ever before. It offers an additional level of financial protection during our economic crisis.”

Warren Gates, Head of Communication, Training and Public Relations at Total Risk Administrators (TRA)

Benefits of Gap Cover with TRA

Financial Protection: TRA’s gap cover policies provide comprehensive protection against unexpected medical expenses, allowing you to focus on your recovery rather than worrying about financial strain.

Peace of Mind: Knowing you have gap cover in place offers peace of mind that you and your family are protected against unforeseen medical costs.

Accessibility: TRA makes gap cover accessible and affordable, with various plans tailored to meet different needs and budgets.

Easy Claims Process: With TRA, the claims process is streamlined and hassle-free, ensuring you receive your benefits promptly.

Is Gap Cover Worth It?

To determine the worth of gap cover, consider the potential financial risk of not having it versus the cost of the premium. For many, the decision boils down to risk management and financial planning.

With medical costs unlikely to decrease, gap cover provides a practical solution for managing these expenses without compromising healthcare quality.

Medical Gap Cover is particularly worth it for:

  • Families with young children or elderly parents
  • Individuals with a history of health issues
  • Those who frequently require specialist care
  • For those seeking comprehensive healthcare coverage without the highest premiums from their medical aid.

Choosing the Right Gap Cover Provider

Total Risk Administrators (TRA) ranks as the best gap cover provider on Hellopeter.

TRA offers a range of gap cover options designed to suit various needs and lifestyles. When choosing the right gap cover, consider factors such as the level of coverage, premium costs, and the inclusion of benefits such as oncology and casualty cover.

TRA’s experienced team can provide you with detailed information about the different gap cover plans, and you or your broker can see what best matches your requirements, ensuring you get the most value from your gap cover.

TRA Makes Your Gap Cover Worth It

In these uncertain times, people seek ways to protect themselves against unpredictable healthcare costs. By investing in gap cover, individuals can have peace of mind knowing they will not be left with unexpected expenses.

South Africans can now take advantage of TRA’s affordable and reliable gap-cover solutions, which help bridge the gap in healthcare protection.

TRA ensures you’re always covered in health. Our gap cover is worth it.

Contact TRA to find the perfect plan for you and your family.

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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