If you have had an expensive medical procedure, and you are a member of a medical aid, you might be sitting in dismay. You’re dismayed because you’ve been given a massive medical bill to pay.
How can it be? Where is your medical aid in all this? Medical aids are paying less and less, they’re offering less benefits and their monthly premiums for members are becoming higher and higher.
Have you heard of medical gap cover? You can only have it if you belong to a registered medical aid, and without it, you might well be staring financial ruin in the face.
Medical gap cover to the rescue
Fusion Gap Cover is considered to be a beautiful product from Xelus because it comes to your rescue. When medical professionals charge the earth, and medical aid only pays a portion of their bill, without this gap cover from Fusion, you will have to pay the shortfall amount.
So essentially, gap cover is an insurance product that covers some huge expenses that your medical aid won’t pay in full.
- Xelus offers their Fusion gap cover product. Fusion doesn’t differentiate between the different medical schemes. You can buy gap cover from Fusion regardless of which medical scheme you belong to.
- Fusion has been specially designed to provide cover for medical shortfalls.
- It will also cover certain out-of-hospital procedures. Some outpatients treatments that Fusion cover are up to 500% of the scheme tariff. They are oncology, dialysis, dental extractions, home births and endoscopes.
- Fusion covers deductibles and co-payments.
- It offers a sub-limit benefit up to a certain amount. There are some in-hospital procedures such as joint replacements that have an annual limit. Once this limit has been reached, the medical scheme won’t provide any additional benefit and the medical aid member is then liable for the shortfall.
Fusion provides a benefit of a certain amount for each condition to cover the shortfalls experienced after reaching these in-hospital sub-limits. - When an oncology benefit goes over the amount offered, Fusion takes care of the co-payment up to a maximum amount. This applies to all costs.
- There is a benefit extender.
- There is a 3 month general waiting period as well as other waiting periods on pre-existing conditions and pregnancy.
- Some exclusions apply.
- You can take the gap cover from Fusion for yourself and for your dependents.
Medical aid gap cover premiums depend a lot on your age. Older people – those over 65 – usually have higher medical expenses, so their premiums are usually higher than those paid by people below the age of 65.
Gap cover is a short term insurance product and by investing in it, it can protect you from devastating financial loss.
Medical aid membership isn’t a ticket to no medical bills
For many South Africans, a medical co-payment bill of R3 000 can be impossible to pay, let alone one of R30 000.
South Africans tend to think that being on a medical aid and paying a huge premium each month exonerates them from all medical bills. That is just a pipe-dream. You pay a premium and you still get to pay lots of medical bills – unless you have gap cover.
Xelus offers their Fusion Gap Cover for good reason – so you don’t have to worry about what your medical aid isn’t paying. This is what makes gap cover so worthwhile.
Use the form on this page to contact us for a quote