What is worse than receiving a bill for medical
treatment even though you are a part of a medical aid scheme? A large medical
bill is not a “surprise” you want. Fortunately, there is a way to ensure that
this does not happen to you.
Gap Cover is ideal for
Non-Comprehensive Medical Aid Plans
If you can’t afford a fully comprehensive medical aid scheme,
you may want to consider getting gap cover.
South
African medical schemes offer various medical aid options with certain prescribed
benefits according to how much you are willing to pay. Medical aids will offer 100%
(or more) cover for health practitioner and medical bills. Many people come
unstuck as they believe that 100% cover means full cover. This is not the case
as specialist in the country are allowed to charge the amount they want for
their services; therefore they can charge a lot more than the medical aid
scheme pays out. Some specialists may even charge a staggering 500% more than
the usual rate for their services. So, depending on the percentage of cover
your medical aid is willing to pay, you will be expected to pay the difference
out of your own pocket.
Gap Cover is a form of medical insurance that you
can pay, over and above your medical aid fees, to ensure that the gap fee,
which is the extra amount charged over and above for medical aid scheme’s
prescribed tariff, is covered.
Benefits of Gap Cover
Different
health insurance companies’ gap cover plans and prices may differ. Admed
Gap Cover Policy offers the following benefits :
- Shortfall cover for Medical Practitioner costs
- Shortfall cover for oncology treatment programmes
- Shortfall cover for internal prosthesis costs
Additional
cover includes:
- A lump sum of money paid for
first-time cancer (stage 2)
- A lump sum of money paid for death caused by
accident or permanent disability
- A lump sum of money for
long-term hospitalisation
- Aid for tooth repairs as a result of damage caused by an
accidental injury
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