Do you need gap cover?

If you are a medical aid member then gap cover is an essential additional cover. Medical schemes may pay 100% of the bill in most instances, but doctors may charge 300% or even more of medical aid rates. Your medical scheme is not obliged to pay these higher rates. You are responsible for the difference between what your medical aid pays, and what your doctor charges.

You can choose between different gap cover options. A single policy can cover you as an individual or your entire family who are members on your medical aid.

• Basic Cover will only pay for up to 300% of in-hospital care. Co-payments are not covered.
• Comprehensive cover will pay for up to 500% of in-hospital care, specific co-payments and certain out-of-hospital procedures.

How to choose a gap cover?

Your choice of gap cover depends on a number of factors. Given the number of choices, here are three questions that you should ask yourself when choosing a medical aid.

1. Does the gap cover have a reliable track record?
2. How extensive are the gap cover benefits?
3. Are there affordable plans for your budget?