Gap cover is a form of short term insurance that covers the gap between what your medical aid will pay and what healthcare professionals charge.

It’s essentially an insurance product that is designed to cover the shortfall.

Medical aid gap cover will generally cover the difference between what your medical scheme is willing to pay and the actual cost of in-hospital doctors’ bills up to a maximum of 500% of the tariff.

Medical aid gap cover is available to individuals currently on a medical scheme.

Medical specialists generally don’t charge rates that the medical aids generally see as being “reasonable” which means that the medical aids don’t pay all their fees.

The reality is that you’re far more likely to get charged a multiple of 3 or 4 times your scheme’s tariff by a specialist.

CompliMed:

CompliMed has an annual limit of R150 000 per insured member.

Members also get cancer co-payment cover as well as a hospital casualty benefit.

Liberty:

For R369 per month, Liberty medical aid gap cover provides guaranteed cover for all applicants. There is no entry age limit and cover is provided for adult dependants at no extra cost.

There is no annual policy limit and cover may be extended above scheme limits. Hospital admission and procedure-specific co-payments are covered with no annual limit.

Sanlam:

Sanlam offers Comprehensive as well as Standard Gap Cover, where the maximum entry age is 59 years. Available for R198 per month and R168 per month respectively, Sanlam medical aid gap cover offers unlimited co-payments.

The Emergency Casualty benefit is for accidental cover only, up to R5000 per event.

There are different medical aid gap cover providers and it’s important to compare various offers if you want to get the best and most affordable medical aid gap cover.

 

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