How Gap Cover Can Help Cover the Shortfalls of Medical Schemes

Health insurance and medical aid schemes are generally considered to be sufficient for covering the cost of emergencies and medical treatments. With the steadily rising costs of health services, the gap between the actual treatment cost and the coverage offered by medical plans is becoming more apparent. To bridge the increasingly growing difference, gap coverage insurance has now become vital. (Information Credit – https://www.gapcover.co.za/gap-cover)

Analysing the Gap

Medical schemes provide a predetermined degree of coverage by charging a fixed amount of premium from you. Apart from a payment ceiling, there are also certain co-payments and sub-limits involved. Combining all these, a difference is created between the actual cost of treatment and the cost reimbursed by the scheme. While this shortfall was bearable in the past, the rapid inflation in medical costs have expanded it manifolds. Ultimately, the huge gap left after utilising the medical aid benefits leaves you stuck with exorbitant amounts, that you need to pay from your pocket.

How Gap Cover Can Help?

Gap coverage insurance or gap cover is an insurance product meant specifically for members of medical schemes. Gap cover doesn’t offer medical cover or medical benefits like medical schemes and health insurances. Rather, GapCover® provides cover for the difference between the actual amount charged by the medical professional or institution, and the cover offered by the medical scheme.

Gap coverage insurance products work with the medical scheme to cover the risk of high costs and provide you with peace of mind when you or your family member require hospital treatment. The benefits of being insured by a gap cover are:

1. Covering Speciality Costs – Gap coverage insurance provides cover for the shortfalls of medical schemes. This includes not only the normal cost of hospital treatments but also the restrictions imposed by medical schemes like co-payments, sub-limits and specialist fees.
2. Cover for You and Your Family – One of the biggest advantages offered by gap cover schemes is that a single product covers you, your spouse and your children who are registered as dependants. This means that you can be assured of peace of mind when anyone in the family needs to be hospitalised.
3. Compatibility and Portability – Gap covers work along with medical schemes to bridge the gap in payments in the best way possible. These are flexible in nature and can be used along with varied kinds of medical schemes. Most gap covers are also portable in nature. This means that when you wish to change your medical aid and switch to a new one, you can transfer your existing gap cover to it.

With the changing scenario of medical aid and hospital costs, the truth remains that medical schemes aren’t solely enough. In many instances, you will find yourself burdened by uncovered medical costs that you will need to pay out of your pockets, hurting your budget. Thus, a gap cover that can cover such shortfalls for you has become a necessity.

About This Author

Tony Pearson Joined: March 13th, 2019