Articles

Gap Cover for Seniors and Pensioners on Medical Aid

Seniors can now enjoy medical gap cover benefits similar to younger medical aid members. Until recently, gap cover insurers had a maximum entry age of 65 years. This means that you could not qualify for medical gap cover after the age of 65 years. There was also an age limit on gap cover whereby the cover ended once a medical […]

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Age Limit (Entry and Exclusions) on Medical Gap Cover

Age is always a concern when it comes to insurance products and this is no different for medical gap cover. Your medical aid cannot impose an age limit. You can join a medical aid at any age, although late joiner penalties apply for members older than 35 years. Similarly you can stay on medical aid cover throughout your life, irrespective […]

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Do You Need Medical Gap Cover on Top of Medical Aid?

Medical aid cover is not a guarantee that all medical expenses will be covered. It is also not a guarantee that 100% of claimed amounts that are covered will be paid in full. Medical schemes pay according to certain tariffs for specific procedures. Your healthcare provider on the other hand may charge different rates for your medical care. Therefore a […]

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Gap Cover for Fertility Treatments and Plastic Surgery

As a general rule, medical gap cover will not pay the shortfall incurred for any treatment that is not covered by your medical aid. Both fertility treatments and plastic surgery are usually not covered by your medical scheme. Therefore gap cover benefits will not apply. However, if there is some underlying factor that has contribute to infertility and needs to […]

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Medical Gap Cover for Pregnancy, Childbirth and Newborn Care

Gap cover for medical aid does have pregnancy and childbirth benefits. This means that shortfalls of any pregnancy-related costs incurred when in hospital, as well as childbirth will be covered. Out-of-hospital treatments, procedures and investigations will not be covered by your gap cover policy. The exclusion will apply to your regular antenatal visits with your gynaecologist, ultrasound scans and blood […]

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How Medical Gap Cover Works and How Much Does It Cost

Medical gap cover is a short term insurance policy that covers medical aid members for shortfalls in payouts. This type of “top up” cover is only available to members on a registered medical aid. Health or medical insurance members are not eligible for gap cover. Although an optional cover, many medical aid members now see it as essential to cover […]

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