In South Africa, the vast majority of individuals would prefer to have access to private healthcare facilities. Yet, despite that, only 16% of the population are members of any kind of medical aid scheme that makes this possible.
But even for those who belong to a medical aid scheme, there are risks – and the escalating cost of medical care should be cause for concern. The fact is that many individuals are unaware of the fact that their medical aid membership may not adequately cover procedures which can be prohibitively expensive. This applies particularly to specialist physicians, whose rates are normally much higher than those of general medical practitioners.
The cost of critical healthcare can also be extremely high, and in the case of treatments like major surgery, long-term care, and treatment of dread diseases, these bills can run to millions of rands.
What Does Gap Cover Do?
Your medical aid scheme provides you with cover for a wide range of medical expenses and procedures. However, some medical expenses exceed your cover limit, and you become responsible for payment of the shortfall. This kind of shortfall can vary from the higher cost of a consultation with a medical specialist, to the dramatically higher expenses incurred by intensive medical procedures that inevitably exceed the cost of routine or planned-for medical care. This is where medical aid gap cover becomes critically important. Gap cover is essentially top-up health insurance that covers the difference between the upper limit of your medical aid cover and the actual cost of consultations, treatments, or procedures. This becomes particularly important if you are faced with medical bills that could leave you in debt, struggling to pay off high bills, and possibly facing a ruinous financial situation. And, when you consider the current state of spiralling medical costs in South Africa, medical aid gap cover should be an essential element of your healthcare solutions planning.Who Can Purchase Medical Aid Gap Cover?
Medical aid gap cover in South Africa is surprisingly inexpensive and offers a great deal of benefit to those who are covered by it. Gap cover does not replace your existing medical aid cover, but complements it – and it isn’t a luxury, but a necessity. So, who can purchase gap cover? The answer may seem self-evident, but you can only take out gap cover if you are already a member of a registered medical aid scheme. You can do this at any time, and your financial advisor will be able to provide you with a list of comparisons and benefits so that you can choose the right cover according to your needs. However, remember that certain categories of medical aid gap cover have built-in waiting periods (just like most medical aid products) – so you can’t suddenly take out gap cover as you’re being hospitalised or wheeled into surgery! The right time to purchase gap cover is before you’re likely to need it, and your financial advisor can help you choose the plan that suits you best.What Employers Should Know About Gap Cover
If you’re an employer, medical aid gap cover is an extremely helpful option to offer your employees. Although it shouldn’t be compulsory, it should be encouraged. For this reason, it’s good practice to have a qualified and experienced healthcare consultant present the options and benefits to your employees. This is important because:- It provides them with an unbiased and independent source of in-depth information.
- It enables a specialist advisor to tailor plans to the specific needs of individual employees.
- It also enables you to offer gap cover as a component of an employee’s total cost to company as part of a benefits package.