What the medical scheme agrees to pay and what the medical specialist bills you are two different things. If you have never heard of medical gap cover, your first medical bill from treatment in-hospital will alert you to find out about the importance of gap cover.
These shortfall amounts that the medical aid won’t pay, will be your responsibility and they can sink you financially.
Gap cover can save you from bankruptcy
With the amount of medical debt you have, you may be tempted to take on even more credit to pay for your bills. Doing this just tightens the noose around your neck. Instead, rather look at gap cover as a realistic way to pay for your medical debt.
Nobody wants to file for bankruptcy, but without gap cover, it will be hard to avoid. It is why Admed gap cover gives wings to medical aid members in South Africa.
Admed is a division of Guardrisk Insurance Company. Their gap cover insurance will take care of the difference that comes about from the rate that specialists charge for in-hospital procedures – often 500% or more higher than the rate paid by your medical scheme.
Don’t pay co-payments and go without treatment
These shortfalls occur because of doctors charging more than the contracted rate with your medical scheme. It also comes about because your medical scheme applies co-payments on certain in-hospital procedures.
If you don’t have the co-payment amount available, then you simply can’t have the treatment you so badly need. Also, there are certain in-hospital appliances that have sub-limits. Gap Cover is just for these in-hospital treatments and doesn’t cover day-to-day medical expenses.
When looking for gap cover, you will need to do research to find the gap cover that can actually help you cope with these shortfalls and co-payments. Many South Africans consider Admed. They offer products that will provide cover for medical expense shortfalls in the event of hospitalisation.
- Admed can offer you more than 100 years of gap cover experience.
- They were the first short-term insurer in South Africa to offer gap cover.
Admed works with medical schemes and other service providers to ensure they can offer their clients a good gap-cover claim experience. - Admed’s products are compatible with all registered medical schemes in South Africa.
- Their gap cover is for all medical scheme members They offer their Supreme Millennial Gap product. It is for under 30-year-olds.
- Their Supreme Gap product is for the main member, their spouse, children and your parents if they are registered as dependents on your medical scheme.
- Their Supreme Pensioner Gap product is for when you are over the age of 65.
- Admed covers you for shortfalls up to 3 times the amount paid by your medical scheme.
- Admed also covers you for certain medical procedures performed out of hospital up to 3 times the amount paid by your medical scheme.
- Emergency accidental casualty benefit.
- Premium waiver benefit
- Co-payments and deductibles cover
- If you are registered to receive oncology treatment with the oncology programme, if you’ve reached your annual benefit limit, Admed will cover the first 20% of the cost.
Healthcare is massively expensive in South Africa and medical aid, while a necessary insurance product, doesn’t cover half of what it should. This is where gap cover comes in and Admed gap cover makes sure you aren’t exposed to such huge shortfalls.
Without the help of Admed gap cover you may never have the wings to rise above your medical bills dilemma. You may well be plunged into financial despair because of medical aids that don’t pay your bills in full.
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