When you or your loved ones are in hospital, financial stress should be the least of your worries and that’s where Gap Cover should be an absolute necessity. There is often a shortfall between what a medical scheme pays and the actual cost of a procedure or treatment, because service providers are entitled to charge more than the medical scheme rate. The shortfall then becomes the member’s responsibility and he/she will therefore need to have additional cover under these circumstances.
Some Hospital and Comprehensive Medical Plans offer cover at 100%, 150% or 200% of medical scheme rates for hospitalisation only, while the actual costs could be more than 500% of medical scheme rates. Gap Cover will cover the difference between what your medical scheme will pay and the actual cost of in-hospital doctor’s bills, up to a maximum of 500% of medical scheme rates.